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全膝关节置换术后引流管的拔管时机对隐性失血的影响

Keywords: 全膝关节置换,引流管,拔管时间,隐性失血

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Abstract:

目的探讨全膝关节置换术(totalkneearthroplasty,TKA)术后不同拔管时间对隐性失血(hiddenbloodloss,HBL)的影响。方法选取2011年9月～2012年9月间于本院完成的初次TKA患者90例,根据拔管时间不同分为24、48和72h拔管组,记录患者体重、身高、术前红细胞压积(hematocrit,Hct),计算所有患者的总失血量、术中出血量、术后引流量,推算出隐性失血量。结果随着引流管留置时间的延长,实际总失血量、显性失血量和术后引流量均逐渐增加,其中实际总失血量三组间差异无统计学意义(P>0.05);引流量、显性失血量和隐性失血量三组间差异有统计学意义(P0.05);72h组引流量明显多于24h组(P<0.01),而隐性失血量24h组和48h组间差异无统计学意义,72h组明显少于24h组和48h组(P<0.01),72h隐性失血只占实际总失血量的20%。结论延长引流管留置时间可显著减少TKA术后隐性失血量,有助于减轻术后肢体肿胀及促进关节功能恢复。

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