摘要
目的探讨初次单膝全膝关节置换术中,止血带的两种使用方法对术后失血量和术后近期疗效的影响。方法回顾分析2010年4月-2013年4月85例膝骨性关节炎行单侧膝关节置换的病例资料。其中A组：手术全程使用止血带（31例）,B组：截骨开始前开始使用止血带,骨水泥固化后放松止血带（54例）。两组患者均采用强生公司RP假体（旋转平台）。记录两组患者手术时间及住院时间;观察下肢静脉血栓形成情况;术后7天行膝前痛视觉模拟评分（Visual analogue scale,VAS）;观察术前、术后2天血红蛋白（Hb）及红细胞压积（Hct）变化情况;术后1年通过西安大略和麦克马斯特大学（West ontario and Mc Maste Universities,WOMAC）骨关节炎指数、美国特种外科医院（HSS）评分,来评价膝关节术后功能和术后并发症。结果术前、术后第2天两组Hb及Hct比较差异无统计学意义（P〉P〈0.05）。A,B两组患者手术时间分别为（86.35±10.21）分钟和（9P〈0.06±11.52）分钟,差异无统计学意义（t=-1.654,=0.116）。患者术后无下肢深静脉血栓形成及肺栓塞发生。两组患者住院时间分别为（7.68±1.26）天和（7.89±1.37）天,差异无统计学意义（t=-1.702,=0.107）,术后7天两组VAS比较差异无统计学意义（t=-1.687,=0.113）;术后1年两组患者HSS评分组间比较无统计学意义;WOMAC评分组间比较没有统计学意义;组内比较差异均有统计学意义（P〈P〈0.05）。结论全膝关节置换置换中,截骨开始前使用止血带的方法可以缩短手术时间,在减少术中术后出血量方面以及术后膝关节功能与手术全程使用止血带没有明显差异,建议截骨开始前使用止血带,以减少止血带使用时间,进而减少相关并发症。
Objective Discuss two methods of using tourniquet during primary unilaterai total knee replacement by the effect of postoperative blood loss and postoperative recently. Methods Retrospective analysis in April 2010 to April 2013,85 cases of knee osteoarthritis cases of unilateral knee joint replacement. The group A： Use tourniquet on operation going（31 cases）, Group B： Using tourniquet before bone cutting, untile bone cement solidified donot relax tourniquet（54cases）. Two groups of patients adopt jj RP prosthetic（rotating platform）. Record operation time and hospital stay in both groups; Observe venous thrombosiso of the lower limb; Line 7 days after knee pain by the Visual analogue scale（Visual analogue scale VAS）; Observe the preoperative and postoperative hemoglobin and red blood cell pressure, the change of the product; Postoperative one year by western Ontario and Mc Master university（West Ontario and Mc Maste Universities WOMAC） osteoarthritis index, the American hospital for special surgery（HSS） score, to evaluate the knee function and postoperative complications after surgery. Results Preoperative and postoperative day Hb and Hct is similar between the two groups has no statistical significance（ P〈0.05）. A, B two groups of patients with operation time were86.35±10.21 points and 9P〈0.06±11.52 points, there was no statistically significant difference（ =1.654, =1.654）. Patients with postoperative lower extremity deep venous thrombosis and pulmonary embolism. Two groups of patients with length of hospital stay was 7.68±1.26 and 7.89±1.37 days, respectively, there was no statistically significant difference（ =1.702,=1.702）, three days after the VAS is similar between the two groups have no statistical significance（ =1.687, =0.113）.One year after surgery is compared between two groups of patients with HSS group had no statistical significance; Comparison between WOMAC group was have no statistical significant; Set of comparative differences are statistically significant（ P〈0.05）. Conclusion In otal knee replacement, the method of use of tourniquet before bone cutting can shorten the operation time, but in less intraoperative blood loss and postoperative knee function compare with full time use of atourniquet have no significant difference, suggested to use tourniquet before bone cut inorder to reduce the time of using tourniquet, and then reduce the telated complications.
出处
《生物骨科材料与临床研究》
CAS
2016年第3期42-44,48,共4页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
全膝关节置换
止血带
失血量
并发症
Total knee replacement
Tourniquet
Blood loss
Complication
