人工全髋关节置换术后关节腔内引流的临床观察

<Abstract>Clinical observation of drainage in articular chamber after total hip arthroplasty (TAH)

目的：通过对引流量、创口愈合及引流液细菌培养的观察分析，确定最佳引流时间。方法：78例手术均放置关节腔引流，分别记录12h、24h、48h的引流量，并根据引流量情况分为24h和48h拔管两组，记录两组创口愈合、引流管出口处渗血情况，分别对三个时段的引流液可引流管体内端进行细菌培养，然后，分析各项数据。结果：平均引流量：12h289ml，24h414ml；48h520ml；12/24h引流量比为69.8％。24/48h引流量比为79.6％。引流量主要发生在24h之内。78例髋术后未发生过深部感染。引流口均自行闭合，大多数未出现明显渗血及渗液现象。留取的12h、24h、48h引流液培养均未见细菌生长；引流末端培养亦未见细菌生长。结论：我们认为对12-24h引流量超过200ml的病例，应再留置引流管12-24h，以免出现引流管口渗血，延迟愈合情况的发生。

Abstract Objective: To define the best drainage time by observation and analysis of drainage quantity, wound healing and bactenium culture for drainage fluid. Methods: In 78 operation caseseach drainage was performed in articular chamber and the drainage quantity was recorded at 12h, 24h and 48h. All cases were divided into two groups in which the concuits were pulled out at 24h and 48h, respectirely, and we recorded the wound healing, and blood oozing at drain entrance in two groups, cultured bacterium with drainage fluid in 3 periods and inside of drain, and made statistical analysis. Results: Average drainage quantity: 12h 289ml, 24h 414ml; 48h 520ml; The rate of 12/24h drainage quantity is 69.8% The rate of 12/24h drainage quantity is 79.6%. Drainage quantity is mainly in 24h. There was no deep infection after all operations. Drain entrances healed all by themselves, and most of them had no blood oozing and fluid oozing. There was no bacterium growing with all drainage fluid and inside of drain. Conclusion: To avoid blood oozing at drain entrance and healing delay, it is better to put the drain more 12~24 hours long, in the case of which drainage quantity is more than 200ml after 12~24h.