调控引流对全膝关节置换术后失血的影响

The efficacy of controlling incision drainage in blood loss after total knee replacement

目的:探讨调控引流对全膝关节置换术后失血的影响。方法:将62例行全膝关节置换术患者随机分为对照组和干预组各31例,对照组患者术后按常规应用闭式负压持续引流,干预组患者应用相同的闭式负压引流装置加用调控开关调节引流量,试验干预于术后10 h终止。术后两组患者均取膝关节伸直位放置引流24 h。比较两组术后24 h引流量及手术前后的血红蛋白(Hb)数值、术后输血量、5 d的膝关节活动度和7 d的髌上周径差。结果:术后24 h引流量、术后输血量干预组低于对照组,术后1 d血红蛋白含量,干预组高于对照组(P>0.05)。两组术后5 d膝关节活动度和7d的髌上周径差差异无统计学意义(P>0.05)。结论:全膝关节置换术后使用调控引流可以减少术后出血。

Objective： To assess the efficacy of controlled-drainage in reducing blood loss after total knee replacement （TKR）. Methods： 62 cases of unilateral TKR patients were randomly divided into experimental group and control group. The control group used single deep closed-suction drain after surgery, while the experimental group used controlled-drainage in the first 10 hours after surgery. Both groups took the extension of knee and drained for 24h after surgery. The volume of drainage in 24h after surgery, hemoglobin concentration before and I day after surgery, volume of blood transfusion after surgery, range of motion （ROM） of knee 5d after surgery and supracondylar perimeter difference 7d after surgery were compared. Results： Hemoglobin concentration 1 day after surgery in experimental group was significant higher than that of control group （P〈0.05）.No significant difference was found in ROM of knee joint 5d after surgery and supracondylar perimeter 7d after surgery between two groups （P〉0.05）. Conclusion： Using controlled-drainage after the TKR can reduce postoperative blood loss.