单髁人工膝关节置换术中是否放置引流的随机对照试验

Drainage is needed or not in UKA:a randomized controlled study

目的探讨单髁人工膝关节置换(UKA)术中是否有必要放置引流。方法选择新疆医科大学第一附属医院关节外科2016年1月-2017年5月行UKA的患者80例为研究对象,随机分为引流组和非引流组,每组40例。引流组患者在关闭切口前放置术区引流管,非引流组不放置引流管,直接关闭切口。记录2组UKA术前及术后1、2、3d内的血红蛋白及红细胞压积值,计算总失血量,评估失血情况;观测患肢URK术后3d、7d、1月、3月疼痛目测类比评分以及感染情况;记录术后1、3、6月时KSS评分及膝关节活动度(ROM)。对2组患者的观测指标进行对比分析。结果 2组患者术前血红蛋白、红细胞压积、VAS评分、KSS功能评分、膝关节ROM等指标经比较差异无统计学意义(P>0.05)。患者术中及术后均未进行输血治疗,至研究截止日均未见膝关节感染情况发生。2组患者UKA术后疼痛目测类比评分、KSS功能评分、膝关节ROM经比较差异无统计学意义(P>0.05),2组第1、2天的血红蛋白、红细胞压积以及总失血量经比较差异有统计学意义(P<0.05),引流组总失血量显著多于非引流组。结论单髁人工膝关节置换术中放置引流对于疾病的治疗及康复并无明显优势,不放置引流亦无不良后果,因此,术者可以考虑不予放置引流管。

Objective To investigate whether it is necessary to place drainage during single knee arthroplasty（UKA）surgery.Methods Eighty patients with UKA who underwent joint surgery in the First Affiliated Hospital of Xinjiang Medical University from January 2016 to May 2017 were selected as subjects.They were randomly divided into drainage group and non drainage group,40 cases in each group.In the drainage group,the drainage tube was used.In the nondrainage group drainage tube was not used.Total blood loss was calculated by recording the hemoglobin and hematocrit before operation and that after1,2,3 days of operation.The pain visual analogue scale scores were examined and analyzed at 3,7 days and 1,3 month postoperatively.Knee Society Scores were recorded at 1,3,6 month postoperatively.Above indexes were compared between the two groups.Results There was no significant difference in hemoglobin,hematocrit,VAS score,KSS function score and knee ROM between the two groups（P 0.05）.No blood transfusion was performed during or after the operation,and no infection of the knee joint was found until the study deadline.There was no significant difference in visual analogy score,KSS function score and ROM of knee joint between the two groups after UKA（P 0.05）.Hemoglobin,hematocrit and total blood loss were significantly different between the two groups on day 1 and 2（P 0.05）.The total blood loss in drainage group was significantly more than that in non-drainage group.Conclusion Placed drainage in unicompartmental knee replacement for the treatment and the rehabilitation of diseases has no obvious advantage,placed nondrainage also no harmful consequences,therefore,the surgeons can consider not to place the drainage.