摘要
目的观察不同体位对初次全膝关节置换术(TKA)后失血量和关节活动度的影响。方法选取90例初次行TKA的患者,随机分为屈曲组和伸直组,每组45例。屈曲组术后采用下肢垫将患侧髋、膝关节均屈曲30°,小腿抬高15 cm;伸直组术后采用伸直位放置患肢。比较两组患肢术后第5天活动度、术后第3天肿胀率、术后48 h总失血量、术后48 h隐性失血量及术后不良反应发生率。结果屈曲组的术后第5天活动度大于伸直组,术后第3天肿胀率、术后48 h总失血量、术后48 h隐性失血量低于或少于伸直组(均P<0.05),但两组术后不良反应发生率差异无统计学意义(P>0.05)。结论微屈抬高患膝可减少初次TKA术后总失血量及隐性失血量,减轻患肢肿胀程度,同时不增加并发症发生率,亦不影响患肢功能活动,利于TKA患者的快速康复。
Objective To observe the impacts of different body postures on blood loss and range of motion after initial total knee arthroplasty(TKA).Methods Ninety patients undergoing initial TKA enrolled were randomly divided into flexion group(45 cases) and extension group(45 cases).The flexion group used low limb pad to bend both of the affected hip and knee 30 degree and elevate the calf 15 cm after operation;the extension group placed the affected lime in extension posture after operation.The two groups were compared with respect to rang of motion on day 5 postoperatively and swelling rate on day 3 postoperatively of the affected limb,total blood loss at 48 h postoperatively,occult blood loss at 48 h postoperatively,and incidence rate of postoperative adverse reactions.Results Compared with the extension group,the flexion group had greater rang of motion on day 5 postoperatively,lower swelling rate on day 3 postoperatively,and less total blood loss and occult blood loss at 48 h postoperatively(all P<0.05),but no statistically significant difference was found in incidence rate of postoperative adverse reactions between the two groups(P>0.05).Conclusion Slightly bending and elevating the affected knee might reduce total blood loss and occult blood loss after initial TKA,and alleviate the affected limb swelling,concurrently,it does not increase the incidence rate of complications,nor affect the functional activity of the affected limb,which is conducive to rapid recovery in TKA patients.
作者
童彬浚
郑炜宏
桑莉莉
吴洪
吴宇峰
高大伟
唐剑邦
TONG Bin-jun;ZHENG Wei-hong;SANG Li-li;WU Hong;WU Yu-feng;GAO Da-wei;TANG Jian-bang(Zhanjiang First Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhanjiang 510405,China;Department of Orthopedics and Joint,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China)
出处
《广西医学》
CAS
2019年第13期1616-1619,共4页
Guangxi Medical Journal
基金
陕西省教育厅科学研究项目(2013JK0782)
关键词
全膝关节置换术
快速康复
术后体位
失血
关节活动度
Total knee arthroplasty
Enhanced recovery
Postoperative body posture
Blood loss
Range of motion
