天津医药 ›› 2015, Vol. 43 ›› Issue (10): 1194-1196.doi: 10.11958/j.issn.0253-9896.2015.10.029

• 应用研究 • 上一篇    下一篇

全膝关节置换术后放置引流与加压包扎对失血量的影响

  

  1. 1天津医科大学总医院滨海医院骨科 (邮编300480); 2天津市人民医院关节外科; 3天津市天津医院关节外科
  • 收稿日期:2015-04-28 修回日期:2015-06-09 出版日期:2015-10-15 发布日期:2015-10-22

Effect of drainge and compressive bandage dressing on blood loss after total knee arthroplasty#br#

  1. 1 Department of Orthopedics, Binhai Hospital of Tianjin Medial University, Tianjin 300480,China; 2 Department of
    Orthopedics, Tianjin PeoplesHospital;3 Department of Joint Orthopaedics, Tianjin Hospital
  • Received:2015-04-28 Revised:2015-06-09 Published:2015-10-15 Online:2015-10-22

摘要:

摘要: 目的 明确全膝关节置换 (TKA) 术后放置引流与加压包扎对术后失血的影响。方法 回顾分析天津医科
大学总医院滨海医院及天津市人民医院骨关节科 2013 1 月—2014 1 月行初次 TKA 治疗的内翻型膝关节骨性
关节炎患者 120 例(120 膝), 男 20 例, 女 100 例, 平均年龄(65.18±6.88)岁。根据是否安置引流将所有患者分为引
流组(60 例)和加压包扎组(60 例)。分析 TKA 术后血常规变化、 失血量和输血情况。结果 引流组和加压包扎组
TKA 术后总体失血量分别为(1 026.85±274.44)、(789.52±251.58mL, 加压包扎组低于引流组(t=4.938P < 0.01)。
术后异体输血: 引流组 14 例, 加压包扎组 5 例, 加压包扎组输血率低于引流组 (χ2=5.065P < 0.05)。2 组患者术后髌
上周径差和关节活动度比较差异均无统计学意义。结论 TKA 术中采用伤口加压包扎手术操作简单, 能够减少患
者围手术期出血、 降低异体输血率。

关键词: 关节成形术, 置换, 膝, 失血, 手术, 负压伤口疗法, 引流术, 全膝关节置换, 加压包扎

Abstract: Abstract: Objective To compare the efficiency of compressive bandage dressing and drainage on the blood loss after
total knee arthroplasty (TKA). Methods Patients (n=120) who visited Tianjin General Hospital Bin Hai Branch and Tianjin
People's Hospital due to varus knee osteoarthritis and underwent TKA were retrospectively analyzed.There are 20 males and
100 females with, mean age was 65.18±6.88 years. Depending on whether placement of drainage, patients were divided into
drainage group (60 cases) and pressure bandage dressing group (60 cases). Blood loss, blood transfusion and full blood count
(FBC) were all analyzed after TKA in both groups. Results Blood loss after TKA in drainage and pressure dressing group
were (1 026.85±274.44),(789.52±251.58) mL respectively. Blood loss was less severe in pressure dressing group than that in
drainage group (t=4.938, P < 0.01). Allogeneic transfusions were needed in 14 cases of drainage group and five cases of pres⁃
sure bandage dressing group. The circumstances that requires blood transfusion was significantly lower in pressure bandage
group than that in drainage group (χ2=5.065, P <0.05). The postoperative limb swelling and postoperative joint mobility did
not show statistical significance (P > 0.05). Conclusion Application of compressive bandage dressing in TKA surgery is
easy to be operate and can reduce perioperative blood loss and allogeneic transfusion incidence.

Key words: arthroplasty, replacement, knee, blood loss, surgical, negative- pressure wound therapy, drainage, total
knee arthroplasty,
pressure dressing