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[1]張津杰,鄭嘉暉,嚴(yán)世貴.兩種不同引流方式對(duì)全膝關(guān)節(jié)置換術(shù)后引流量和失血量的影響[J].中醫(yī)正骨,2018,30(07):14-16,24.
　ZHANG Jinjie,ZHENG Jiahui,YAN Shigui.Effect of two kinds of drainage on volume of drainage and blood loss after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(07):14-16,24.
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兩種不同引流方式對(duì)全膝關(guān)節(jié)置換術(shù)后引流量和失血量的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年07期
頁(yè)碼:
14-16,24
欄目:
臨床研究
出版日期:
2018-07-20

文章信息/Info

Title:
Effect of two kinds of drainage on volume of drainage and blood loss after total knee arthroplasty
作者:
張津杰1; 鄭嘉暉2; 嚴(yán)世貴3
(1.浙江省中醫(yī)院,浙江 杭州 310006; 2.浙江中醫(yī)藥大學(xué),浙江 杭州 310053; 3.浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院,浙江 杭州 310009)
Author(s):
ZHANG Jinjie1; ZHENG Jiahui2; YAN Shigui3
1.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China 2.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 3.The Second Affiliated Hospital of Medical School of Zhejiang University,Hangzhou 310009,Zhejiang,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  引流術(shù);  手術(shù)后出血
Keywords:
arthroplasty; replacement; knee;  drainage;  postoperative hemorrhage
摘要:
目的:比較常壓轉(zhuǎn)負(fù)壓引流和夾閉后轉(zhuǎn)負(fù)壓引流2種引流方式對(duì)全膝關(guān)節(jié)置換(total knee arthroplasty,TKA)術(shù)后引流量和失血量的影響。方法:回顧性分析2014年1月1日至2015年3月1日,在浙江省中醫(yī)院接受初次單側(cè)TKA的94例患者的病例資料。術(shù)中植入引流管后,44例患者采用常壓引流12 h再轉(zhuǎn)成負(fù)壓引流(常壓轉(zhuǎn)負(fù)壓引流組),50例患者采用夾閉引流管4 h后打開引流管持續(xù)負(fù)壓引流(夾閉后轉(zhuǎn)負(fù)壓引流組)。均在24 h引流量<50 mL時(shí)拔管。比較2組患者的引流時(shí)間、術(shù)后各時(shí)間段(0～6 h、>6～12 h、>12～24 h、>24 h)引流量、總引流量及術(shù)后24 h總失血量。結(jié)果:術(shù)后不同時(shí)間段引流量的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=53.491,P=0.000)。2組患者術(shù)后6～12 h引流量均達(dá)到高峰。2組患者術(shù)后引流量總體比較,差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=212.801,P=0.000)。術(shù)后各個(gè)時(shí)間段,常壓轉(zhuǎn)負(fù)壓引流組引流量均低于夾閉后轉(zhuǎn)負(fù)壓引流組[(40.34±32.63)mL,(86.10±66.65)mL,t=-4.137,P=0.000;(59.55±26.80)mL,(145.72±59.51)mL,t=-8.844,P=0.000;(36.71±16.60)mL,(103.80±35.06)mL,t=-11.597,P=0.000;(18.75±8.70)mL,(40.16±17.45)mL,t=-7.370,P=0.000]。時(shí)間因素和分組因素存在交互效應(yīng)(F=11.538,P=0.000)。2組患者引流時(shí)間的組間差異無(wú)統(tǒng)計(jì)學(xué)意義[(38.70±7.23)h,(37.74±0.81)h; t=0.933,P=0.590],但常壓轉(zhuǎn)負(fù)壓引流組術(shù)后總引流量和術(shù)后24 h總失血量均較夾閉后轉(zhuǎn)負(fù)壓引流組少[(155.34±48.80)mL,(375.78±89.13)mL,t=-15.104,P=0.000;(692.52±258.72)mL,(843.25±310.11)mL; t=-2.031,P=0.045]。結(jié)論:初次單側(cè)TKA術(shù)后,采用常壓轉(zhuǎn)負(fù)壓引流和夾閉后轉(zhuǎn)負(fù)壓引流2種引流方式,引流時(shí)間相當(dāng),但前者的術(shù)后引流量和術(shù)后24 h總失血量均小于后者。
Abstract:
Objective:To compare the effects of negative-pressure drainage following normal-pressure drainage versus negative-pressure drainage following closing drainage tube on volume of drainage and blood loss after total knee arthroplasty(TKA).Methods:The medical records of 94 patients who received primary unilateral TKA in Zhejiang Provincial Hospital of Traditional Chinese Medicine from 1 January 2014 to 1 March 2015 were analyzed retrospectively.After intraoperative implantation of drainage tube,44 patients were treated with negative-pressure drainage following 12-hour normal-pressure drainage(group A),while 50 patients were treated with negative-pressure drainage following closing drainage tube for 4 hours(group B).The drainage tubes were removed when the volume of 24-hour drainage was of<50 mL.The drainage time,volume of drainage at different postoperative time periods(0-6 hrs,>6-12 hrs,>12-24 hrs,>24 hrs),total volume of drainage and total postoperative 24-hour blood loss were compared between the 2 groups.Results:There was statistical difference in volume of drainage between different postoperative timeperiods,in other words,there was time effect(F=53.491,P=0.000).The volume of drainage peaked at 6-12 hours after the surgery in both of the 2 groups.There was statistical difference postoperative volume of drainage between the 2 groups in general,in other words,there was group effect(F=212.801,P=0.000).The volume of drainage was less in group A compared to group B in all postoperative timeperiods(40.34+/-32.63 vs 86.10+/-66.65 mL,t=-4.137,P=0.000; 59.55+/-26.80 vs 145.72+/-59.51 mL,t=-8.844,P=0.000; 36.71+/-16.60 vs 103.80+/-35.06 mL,t=-11.597,P=0.000; 18.75+/-8.70 vs 40.16+/-17.45 mL,t=-7.370,P=0.000).There was interaction between time factor and group factor(F=11.538,P=0.000).There was no statistical difference in drainage time between the 2 groups(38.70+/-7.23 vs 37.74+/-0.81 hrs,t=0.933,P=0.590),while postoperative total volume of drainage and postoperative total 24-hour blood loss were less in group A compared to group B(155.34+/-48.80 vs 375.78+/-89.13 mL,t=-15.104,P=0.000; 692.52+/-258.72 vs 843.25+/-310.11 mL,t=-2.031,P=0.045).Conclusion:Negative-pressure drainage following normal-pressure drainage is similar to negative-pressure drainage following closing drainage tube in drainage time after primary unilateral TKA,however,the former has the advantages of less postoperative volume of drainage and less postoperative 24-hour blood loss compared to the latter.

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備注/Memo

備注/Memo:
通訊作者:嚴(yán)世貴 E-mail:[email protected]
更新日期/Last Update: 2018-11-30