负压引流技术在全膝关节置换术后的联合应用研究进展

Research progress of combined application of negative pressure drainage after total knee replacement

全膝关节置换术(TKA)是目前治疗终末期膝关节骨性关节炎的金标准。且经过TKA几十年的发展与创新,闭式负压引流(CSD)技术的联合应用作为常规引流方案被广泛应用于TKA术后,被认为在TKA术后能够明显减少血肿的形成、缓解疼痛、加速伤口愈合、促进患肢功能康复、推动术后快速康复计划理念的实施,但同时又可能增加TKA术后失血量,从而导致患者输血率增加、住院时间延长等。对于CSD技术在TKA术后的联合应用目前仍存在争议,本文将对TKA术后CSD技术的联合应用方法及其研究进展做一综述,主要方法有CSD技术联合夹管技术、常压转负压方案、负压伤口疗法、控制器调节压力方案、CSD技术联合自体血回输及关节腔内氨甲环酸注射等,以期为临床医生提供参考。

Total knee arthroplasty(TKA)is currently the gold standard for the treatment of end-stage knee osteoarthritis.And after decades of development and innovation of TKA,the combined application of closed negative pressure drainage(CSD)technology has been widely used as a conventional drainage solution after TKA.It is believed to significantly reduce the formation and relief of hematoma after TKA.Pain,accelerate wound healing,promote the rehabilitation of affected limbs,and promote the implementation of the concept of rapid postoperative recovery plans,but at the same time it may increase the blood loss after TKA,which will lead to an increase in the patient’s blood transfusion rate and longer hospital stays.There is still controversy about the combined application of CSD technology after TKA.This article will review the combined application methods and research progress of CSD technology after TKA.The main methods include CSD technology combined with clamp technology,normal pressure to negative pressure program,negative pressure wound therapy,controller pressure adjustment program,CSD technology combined with autologous blood transfusion and intra-articular tranexamic acid injection,etc.,in order to provide reference for clinicians.