膝关节置换引流管理的研究进展

Research progress on drainage management of total knee arthroplasty

膝关节置换被誉为20世纪最成功的手术之一,称为世纪性手术。近年来随着快速康复理念的推广,膝关节置换的围手术期管理问题再度成为焦点和热点。其中膝关节置换的引流问题就是焦点之一,出血多、引流量大一直是膝关节置换引流的主要问题,随之引起伤口感染、假体周围感染、康复困难等一系列并发症。因此如何减少出血,减少引流量,促进快速康复是膝关节置换引流管理的重点。目前对于膝关节置换的引流问题还没有一个清晰的临床指导,本文旨在回顾文献,提供引流管理的相关经验,主要包括术中止血、止血带使用、氨甲环酸的使用、引流管夹闭与放置时间、引流管拔除时间、抗凝药物的使用等。

Knee arthroplasty is praised as one of the 20th century＇ s most successful surgery, known as ＂Century Surgery＂. In recent years, with the development of the concept of rapid recovery, perioperative management of knee arthroplasty is considered as the focus once again. While the drainage is one of the focus with the possibility of excessive bleeding and drainage, which could result in complications such as wound infec- tion, periprosthetic infection, and rehabihtation problems. So how to reduce bleeding and the amour of drainage, and facilitate rapid recovery is the key in the management of drainage during knee arthroplasty. Currently there are no clear clinical guidelines of drainage problems during knee arthroplasty, while we aim to review the literature, and provide drainage management experience including hemostasis, the use of tourniquet and tranexamic acid, the time point of occlusion and removement of the drainage tube, and the use of anticoagulant drugs.