摘要
目的:研究术中放置引流管对初次全膝关节置换术(TKA)患者围手术期失血量及术后疼痛的影响。方法:回顾性分析行单侧TKA手术的100例患者的临床资料。依据术中是否放置引流管将患者分为引流管组(67例)和无引流管组(33例)。比较两组患者术前及术后第1、3天血红蛋白(Hb)、红细胞压积(Hct)、C-反应蛋白(CRP)水平、围手术期失血量。记录手术前后视觉模拟量表(VAS)评分,术后下肢深静脉血栓(DVT)、肺栓塞、输血、患肢肿胀发生率,以及住院时间并进行比较。结果:两组术前及术后第1、3天Hb、Hct和CRP组内两两比较差异有统计学意义(均P<0.05),但组间比较差异无统计学意义(均P>0.05)。两组总失血量比较差异无统计学意义(P>0.05),但引流管组隐性失血量小于无引流管组,显性失血量大于无引流管组(均P<0.05)。两组术后DVT、肺栓塞、输血发生率及住院时间比较差异无统计学意义(均P>0.05)。无引流管组术后患肢肿胀发生率高于引流管组(P<0.05)。两组术后第1、3天VAS评分比较差异有统计学意义(均P<0.05),且组内术后第1、3天VAS评分高于术前(均P<0.05)。结论:TKA术中引流管的放置不影响患者围手术期CRP、总失血量、血栓发生率、术后输血率和住院时间,但不放置引流管可增加围手术期隐性失血量和患肢肿胀发生率,加重患者术后疼痛感受。
Objective:To investigate the effect of intraoperative drainage tube placement on perioperative blood loss and postoperative pain in patients undergoing primary total knee arthroplasty(TKA).Methods:The clinical data of 100 patients who underwent unilateral TKA were retrospectively analyzed.The patients were divided into drainage tube group(67 cases)and non-drainage tube group(33 cases)according to whetheRdrainage tube was placed.The levels of hemoglobin(Hb),hematocrit(Hct),C-reactive protein(CRP)and perioperative blood loss were compared between the two groups.Visual analog scale(VAS)scores,incidence of loweRextremity deep venous thrombosis(DVT),pulmonary embolism,blood transfusion,swelling of affected limb,and hospital stay before and afteRsurgery were recorded and compared.Results:Hb,Hct and CRP levels before surgery,on the 1st day and the 3rd day afteRsurgery were statistically significant in the two groups(all P<0.05),but there was no statistical difference between the two groups(all P>0.05).There was no significant difference in the total blood loss between the two groups(P>0.05),but the hidden blood loss in the drainage tube group was less than that in the non-drainage tube group,and the apparent blood loss was greateRthan that in the non-drainage tube group(all P<0.05).The incidence of postoperative DVT,pulmonary embolism,blood transfusion and hospital stay in the two groups were not significantly different(all P>0.05).The incidence of postoperative swelling of the affected limb in the non-drainage tube group was higheRthan that in the drainage tube group(P<0.05).The VAS scores of the two groups on the 1st and 3rd days afteRoperation were statistically significant(all P<0.05),and the VAS scores in the group on the 1st and 3rd days afteRoperation were higheRthan those before operation(all P<0.05).Conclusion:The placement of drainage tube during TKA does not affect perioperative CRP,total blood loss,incidence of thrombus,postoperative blood transfusion rate and hospital stay,but no placement of drainage tube can increase perioperative hidden blood loss and incidence of limb swelling,and aggravate postoperative pain.
作者
杨天翔
张博文
张晋宁
宋国瑞
张晨
刘子歌
陈德胜
YANG Tianxiang;ZHANG Bowen;ZHANG Jinning;Song Guorui;Zhang Chen;LIU Zige;CHEN Desheng(School of Clinical Medicine,Ningxia Medical University,Yinchuan 750004,China)
出处
《陕西医学杂志》
CAS
2022年第12期1548-1551,1556,共5页
Shaanxi Medical Journal
基金
国家自然科学基金资助项目(82060408)
宁夏回族自治区重点研发计划项目(2021BEG03049)
宁夏回族自治区留学人员创新创业项目(2020-75)
宁夏回族自治区高等学校一流学科建设资助项目(NXYLXK2017A05)。
关键词
膝骨关节炎
引流管
全膝关节置换术
围手术期
失血量
疼痛
Knee osteoarthritis
Drainage tube
Total knee arthroplasty
Peroperative period
Blood loss
Pain
