气压止血仪不同压力参数对行全膝关节置换术患者的影响

Effects of Different Pressure Parameters of Pneumatic Hemostasis Instrument on Patients Undergoing Total Knee Arthroplasty

目的探讨气压止血仪不同压力参数对行全膝关节置换术(TKA)患者的影响。方法选取2019年1月至2022年6月住院并拟行单侧TKA(初次)治疗的74例患者为研究对象,采用随机数字表法分为对照组与观察组,各37例。两组均于切皮前行常规屈膝驱血,在大腿根部系上止血带。对照组气压止血仪压力设置为45 kPa,观察组设置为患者收缩压+15 kPa。比较两组术中出血量、术后48 h内伤口总引流量、术中止血效果、术后皮肤状况及术后膝关节功能恢复情况。结果观察组术中出血量及术后48 h内伤口总引流量均少于对照组,术中止血优良率及术后皮肤状况优良率均高于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组美国纽约特种外科医院(HSS)膝关节功能评分表评分高于对照组,差异有统计学意义(P<0.05)。结论根据TKA患者收缩压设定个体化的止血带压力不仅具有良好的止血效果,还可改善皮肤状况,促进术后膝关节功能恢复。

Objective To explore the effects of different pressure parameters of pneumatic hemostatic instrument on patients undergoing total knee arthroplasty(TKA).Methods A total of 74 patients who were hospitalized in the hospital and planned to undergo unilateral TKA for the first time from January 2019 to June 2022 were selected as the study objects and randomly divided into a control group and an observation group by using a random number table,with 37 cases in each group.Before the skin incision,the patients in the two groups bent their knees to expel blood,and a pneumatic tourniquet was put on the root of the thigh.The pressure of the pneumatic hemostasis instrument in the control group was set as 45 kPa,and the pressure in the observation group was set as systolic blood pressure plus 15 kPa.The intraoperative blood loss,the total amount of wound drainage within 48 hours after operation,the intraoperative hemostasis effect,the postoperative skin condition and postoperative knee joint function recovery were compared between the two groups.Results The intraoperative blood loss and the total amount of wound drainage within 48 hours after operation in the observation group were less than those in the control group,the excellent rate of intraoperative hemostasis and postoperative skin condition were higher than those in the control group,with statistically significant differences(P<0.05).3 months after operation,the American New York Hospital for Special Surgery(HSS)knee joint function scale scores in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).Conclusion Setting individualized tourniquet pressure according to the patient's systolic blood pressure not only has a good hemostatic effect,but also can improve skin condition and promote the recovery of knee joint function after surgery.