两种引流方式在单侧膝关节置换术后的前瞻性临床对比研究

目的:分析和比较单侧膝关节置换使用氨甲环酸术后两种不同引流方式(不夹管,夹管6小时后持续开放)对于手术的影响(出血量;并发症;康复锻炼等)。方法:根据纳入及排除标准,随机的将2015年6月-2017年6月在我院行单侧人工全膝关节置换的共计52例患者分为两组(不夹管组;夹管6小时后持续开放组)进行研究。每组各26例患者。分别观察和比较两组患者的各项术后资料:总引流量,总输血量,总失血量,小腿周径增幅,并发症等。同时对两组患者的膝关节功能进行评估和比较。结果:两组患者在年龄、性别组成、等一般临床资料的比较中未见显著差异(P0.05)。不夹管组的总失血量,总引流量,隐性失血量,输血量等指标显著高于夹管6小时组(P0.05)。术后两组患者在血栓,感染等并发症及小腿周径增幅等方面未见显著差异(P0.05)。结论:单侧膝关节置换术后早期进行夹管能够有效的减少总失血量、引流量等指标,更有利于患者术后的早期康复,而且不增加并发症的发生。

Clinical Effects of Primary Total Knee Arthroplasty with Different Drainage Ways

ABSTRACT Objective: The aim of this study was to evaluate the clinical effects in patients who had undergone primary total knee arthroplasty (TKA) with 2 different closed negative pressure drainage (not clip pipe; clip to remain open after 6 hours). Methods: A total of 52 patients (52 knees) underwent primary TKA in our hospital from 2015.06 to 2017.06 was conducted. They were randomly divided into two groups (don''t clip pipe group, clip pipe 6 h). Comparing three groups of patients with postoperative total flow rate and amount of allogeneic blood transfusion, total blood loss and hidden blood loss, postoperative week diameter growth of leg, incision infection rate, incidence of thrombosis and the function of knee joint after December (HSS score) evaluate the situation. Results: There were no signifi- cant difference in the baseline characteristics including age, gender, height, weight and time of operation between the two groups (P> 0.05). However, total blood loss, hidden blood loss, blood transfusion in study group were higher than that in control group (P<0.05). Multiple comparison between groups of patients, postoperative 1 d, 3 d weeks diameter growth of leg, postoperative incidence of throm- bosis, incision infection rate and postoperative HSS score 12 months were no significant statistical difference (P>0.05). Conclusion: Early continuous negative pressure drainage after clip pipe (6 h) can significantly reduce the amount of blood loss and the blood transfusion rate, and do not increase the obvious adverse consequences.