全膝置换围手术期失血量因素分析

Analysis on Perioperative Blood Loss Factor in Total Knee Arthroplasty

目的探讨使用止血带不同方法对全膝关节围手术期出血量的影响.方法将59例接受单侧全膝关节置换的患者随机分为两组,一组在行TKA手术全程中使用止血带,另一组在完成截骨后使用止血带、在骨水泥固化后松开止血带,以手术时间、围手术期失血量作为评价指标,对两组进行比较.使用Gross及Nadler公式计算围手术期总出血量.结果非全程止血带组术后首日总出血量明显多于全程止血带组,差异具有统计学意义(P<0.05);术后第3天,比较两组总出血量差异无统计学意义(P>0.05).纳入研究的患者术后均无关节血肿、深静脉血栓等并发症发生.结论全程使用止血带并不能减少TKA围手术期总出血量.

Objective To explore the influence of the different strategies for using tourniquet on perioperative bleed loss in total knee arthroplasty（ TKA）. Methods A total of 59 patients who underwent TKA were randomized into two groups. In group 1（29 patients）,the tourniquet was inflated just before incision and deflated after the last suture of the skin. In group 2（30 patients）,the tourniquet was inflated after osteotomy and deflated after the bone cement solidified. Gross and Nadler formulas were used to calculate the total perioperative blood loss. Results The estimated blood loss in group 1 was significantly lower than in group 2 on the first postoperative day（ P 〈0. 05）. No significant difference on the total blood loss between the two groups was detectable on the third postoperative day（ P〉0. 05）. No complications such as joint hematoma and deep vein thrombosis appeared in both groups. Conclusion All course tourniquet application can not reduce the total perioperative blood loss in TKA.