[1]张津杰,郑嘉晖,严世贵.两种不同引流方式对全膝关节置换术后引流量和失血量的影响[J].中医正骨,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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两种不同引流方式对全膝关节置换术后引流量和失血量的影响()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年07期
页码:
14-16,24
栏目:
临床研究
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:
张津杰1; 郑嘉晖2; 严世贵3
(1.浙江省中医院,浙江 杭州 310006; 2.浙江中医药大学,浙江 杭州 310053; 3.浙江大学医学院附属第二医院,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
关键词:
关节成形术; 置换; 膝;  引流术;  手术后出血
Keywords:
arthroplasty; replacement; knee;  drainage;  postoperative hemorrhage
摘要:
目的:比较常压转负压引流和夹闭后转负压引流2种引流方式对全膝关节置换(total knee arthroplasty,TKA)术后引流量和失血量的影响。方法:回顾性分析2014年1月1日至2015年3月1日,在浙江省中医院接受初次单侧TKA的94例患者的病例资料。术中植入引流管后,44例患者采用常压引流12 h再转成负压引流(常压转负压引流组),50例患者采用夹闭引流管4 h后打开引流管持续负压引流(夹闭后转负压引流组)。均在24 h引流量<50 mL时拔管。比较2组患者的引流时间、术后各时间段(0～6 h、>6～12 h、>12～24 h、>24 h)引流量、总引流量及术后24 h总失血量。结果:术后不同时间段引流量的差异有统计学意义,即存在时间效应(F=53.491,P=0.000)。2组患者术后6～12 h引流量均达到高峰。2组患者术后引流量总体比较,差异有统计学意义,即存在分组效应(F=212.801,P=0.000)。术后各个时间段,常压转负压引流组引流量均低于夹闭后转负压引流组[(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]。时间因素和分组因素存在交互效应(F=11.538,P=0.000)。2组患者引流时间的组间差异无统计学意义[(38.70±7.23)h,(37.74±0.81)h; t=0.933,P=0.590],但常压转负压引流组术后总引流量和术后24 h总失血量均较夹闭后转负压引流组少[(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]。结论:初次单侧TKA术后,采用常压转负压引流和夹闭后转负压引流2种引流方式,引流时间相当,但前者的术后引流量和术后24 h总失血量均小于后者。
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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备注/Memo

备注/Memo:
通讯作者:严世贵 E-mail:zrjwsj@zju.edu.cn
更新日期/Last Update: 2018-11-30