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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。

References

[1]  赵谦,毕树雄,卫小春,等.初次关节置换术后引流拔除时机的研究进展[J].中国矫形外科杂志,2010,18(5):409-411.
[2]  Gross JB.Estimating allowable blood loss:corrected for dilution[J].Anesthesiology,1983,58:277- 280.
[3]  Nadler SB,Hidalgo JU,Bloch T.Prediction of blood volume in normal human adults[J].Surgery,1962,57:224-232.
[4]  Malone KJ,Matuszak S,Mayo D,et al.The effect of intra-articular epinephrine lavage on blood loss following total knee arthroplasty[J].Orthopedics,2009,32(2):100.
[5]  Stainsby D,Maclennan.Guidelines on the management of massive blood loss [J].Br J Haematol,2006,135(5):634-641.
[6]  Foss NB,Kehlet H.Hidden blood loss after surgery for hip fracture [J].J Bone Joint Surg Br,2006,88(8):1053-1059.
[7]  Anderson LA,Engel GM,Bruckner JD,et al.Reduced blood loss after total knee arthroplasty with local injection of bupivacaine and epinephrine [J].J Knee Surg,2009,22(2):130-136.
[8]  高福强,李子剑,刘延青,等.初次全膝关节置换术后肢体肿胀程度与隐性失血量的相关性研究[J].中国矫形外科杂志,2011,19(3):199-202.
[9]  覃健,余存泰,徐中和,等.全髋关节及全膝关节置换术后隐性失血的临床影响[J].中华骨科杂志,2006,26(5):323-326.
[10]  陈德胜.隐性失血对双侧人工全膝关节同期置换手术的影响[J].中国矫形外科杂志,2007,15(17):1290-1292.
[11]  Minnema B, Vearncombe M. AugustinA1Risk factors for surgical site infection follow ingprimary total knee arthroplasty[J].Infect Control Hosp Epidemiol,2004,25:477-4801.
[12]  Ares-Rodriguez O, Martinez AH. FernandezAH1Survival curve and factors related to drainage during the first 24h after total knee arthroplasty[J].J Knee Surg Sports Traumatol Arthrosc,2008,16:585-589.
[13]  Esler CN, Blakeway C, Fiddian NJ. The use of a closed-suction drain in total knee arthroplasty. A prospective, randomized study[J].J Bone Joint Surg B,2003,85(2):215-217.

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