初次全膝关节置换术后放置与不放置引流对术后快速康复的影响

Effect of Placing Drainage or Not on Rapid Rehabilitation after Primary Total Knee Arthroplasty

目的探讨初次全膝关节置换术(TKA)后放置与不放置引流对术后快速康复的影响。方法回顾性分析2018年1月至2020年9月本院接受初次TKA的膝骨关节炎患者80例。A组(n=40)术后常规放置引流管,B组(n=40)术后不放置引流管,比较两组术后血清炎症因子指标、术后疼痛评分、术后并发症发生率、术后离床活动时间、住院时间、膝关节功能评分、膝关节活动度和世界卫生组织生活质量简表评分。结果术后第1~3天,两组C反应蛋白水平无显著性差异(t<0.410,P>0.05)。术后12~48 h,两组疼痛VAS评分无显著性差异(t<0.300,P>0.05)。A组术后并发症发生率为5.0%,B组为2.5%,无显著性差异(χ2=0.346,P>0.05)。B组术后离床活动时间、住院时间均显著短于A组(t>4.863,P<0.001)。两组手术后的膝关节功能评分、膝关节活动度和生活质量评分均显著增加(t>6.099,P<0.001),但两组间比较均无显著性差异(P>0.05)。结论TKA后放置与不放置引流不影响患者的术后并发症、膝关节功能改善情况和生活质量提高情况,但不放置引流可加快患者术后康复,促使患者尽早出院。

Objective To explore the effect of placing drainage or not on rapid rehabilitation after total knee arthroplasty(TKA).Methods From January,2018 to September,2020,80 patients with knee osteoarthritis who underwent primary TKA in our hospital were analyzed retrospectively,and they were divided into groups A and B,with 40 cases in each group.Drainage was placed routinely in group A and not in group B.The postoperative serum inflammatory factors,postoperative pain score,postoperative complication rate,postoperative time out of bed,hospital stay,knee function score,range of motion of knee and World Health Organization Quality Of Life-abbreviated version score(WHOQOL-BREF)were compared between two groups.Results There was no significant difference in the levels of C-reactive protein between two groups on the 1st to 3rd day after operation(t<0.410,P>0.05).There was no significant difference in Visual Analogue Score between two groups from 12 h to 48 h after operation(t<0.300,P>0.05).The incidences of postoperative complications were 5.0%in group A and 2.5%in group B,with no significant difference between two groups(χ2=0.346,P>0.05).The time of getting out of bed and hospital stay was significantly shorter in group B than in group A(t>4.863,P<0.001).The scores of knee joint function,range of motion of knee and WHOQOL-BREF significantly increased after operation in both groups(t>6.099,P<0.001),however,there was no significant difference between two groups(P>0.05).Conclusion Placement or non-placement of drainage after primary TKA does not affect postoperative complications,knee joint function and quality of life of patients with knee osteoarthritis,however,non-placement of drainage can promote postoperative recovery and discharge.