摘要
目的探讨全膝关节置换(TKA)术后膝关节抬高屈曲位是否有效减少术后出血。方法 60例TKA患者术后随机分成A、B两组,各30例。A组:术后采用自制组配式抬高支架将手术膝置于大腿抬高60°屈膝45°位;B组:患肢小腿下垫枕抬高伸直位。术后两组均放置负压引流24h。比较两组术后24h出血负压引流量、术前和术后血红蛋白差值、两组术后24小时疼痛评分和并发症。结果术后24h的总引流量,A组为(331·75±55·04)ml,B组为(558·52±94·36)ml,两组间的差异有统计学意义(P<0·05)。术前和术后血红蛋白的差值,A组为(2·8±1·1)g/dl,B组为(3·6±1·2)g/dl,两组间的差异有统计学意义(P<0·05)。术后疼痛VAS评分,A组为(4·9±0·6),B组为(5·1±0·5),两组间差异无统计学意义。两组患者在住院期间、术后3个月随访时均未发现感染以及其他并发症的发生。结论 TKA术后膝关节抬高屈曲位能有效地减少术后出血。
Objective To assess the efficacy of reducing the blood loss with leg elevated 60^.and knee flexed to 45^. after total knee arthroplasty. Methods In a randomized trail, 60 primary total knee arthroplasties were assigned to two groups with 30 cases each. Group A： leg was elevated 60^. with knee flexed to 45^. on the modular bracket made by ourselves. Group B： the knee was extend with one pillow under the leg. Wound drainage was removed 24 hours after surgery in both groups. The 24-hour volume of the drainage and complications were assessed. The differential between the preoperative and postoperative haemoglobins was calculated. Results The 24-hour volume of the drainage in two groups were （331.75±55.04） ml and （558.52 ±94. 36）ml, respectively. The differentials between the preoperative and postoperative haemoglobins in group A and B were （2. ±1.1 ） g/dl and （3.6±1.2） g/dl, respectively. There was statistically significant difference between the two groups. There was no difference between two groups with respect to Visual analog scores for 24-hour postoperative pain. No wound infection or other complication was found in both groups within three months after surgery. Conclusions The position of the leg elevated 60^. with knee flexed to 45^. on the modular bracket is recommended for reducing blood loss after total knee arthroplasty.
出处
《中华关节外科杂志（电子版）》
CAS
2011年第2期19-21,共3页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节成形术
置换
膝
体位
手术后出血
Arthroplasty, replacement, knee
Posture
Postoperative hemorrhage
