摘要
目的分析止血带对膝关节置换术(TKA)围手术期失血量和深静脉血栓(DVT)发生率的影响。方法自2007年1月至2009年12月217例在我院初次单侧膝关节置换术患者,入院后随机分为两组:实验组112例,在安装假体、骨水泥固化后释放止血带,彻底止血后缝合切口;对照组105例,在缝合切口,加压包扎后释放止血带;比较两组患者止血带使用时间、术中和术后失血、总失血量以及术后深静脉栓塞发生率。结果实验组患者止血带时间为(78.7±11.3)分钟,术中失血(110.5±51.6)ml,术后失血(220.6±135.0)ml,总失血量(329.8±180.2)ml,术后并发深静脉栓塞18例;对照组患者止血带时间为(85.6±10.5)分钟,术中失血(90.2±58.6)ml,术后失血(382.7±156.3)ml,总失血量(480.3±191.5)ml,术后并发深静脉栓塞32例。两组比较实验组总失血量和DVT发生率均较对照组低。结论 TKA术中在安装假体、骨水泥固化后再释放止血带,创面止血能够减少围手术期失血量,DVT的发生率却未增加。
Objective To analyze the effect of tourniquet application to blood loss and deep vein thrombosis（DVT） in perioperation of total knee arthroplasty（TKA）.Methods The clinical data of 217 cases,who were operated with primary ipsilateral TKA from Jan.2007 to Dec.2009,were divided into two groups ramdomly by registration：112 cases in the experimental group who were operated with tourniquet release and then surgery hemostasis before wound closure,and 105 cases in the control group who were operated with tourniquet release after wound closure and pressure dressing.The two groups were compared in terms of using tourniquet time,intraoperative and postoperative bleeding,total blood loss and the incidence of deep vein thrombosis.Results The time of using tourniquet was（78.7 ±11.3） minutes,the quantities blood loss in operation procedure was（110.5 ± 51.6）ml,the quantities blood loss postoperation was（220.6 ± 135.0） ml,the total blood loss was（329.8 ± 180.2） ml and the incidence of deep vein thrombosis was 18/112 in the experimental group;the value was（85.6 ± 10.5） min,（90.2 ± 58.6） ml,（382.7 ± 156.3） ml,（480.3 ± 191.5） ml,and 32/105 respectively in the control group.The total blood loss and the DVT incidence in the experimental group were less than those in the control group.Conclusion Introoperative TKA with tourniquet release and hemostasise after the component implantion and cement hardened can fully decrease perioperative blood loss and the risk of postoperative DVT complications.
出处
《临床医学工程》
2011年第8期1179-1180,1183,共3页
Clinical Medicine & Engineering
基金
广东省医学类科技攻关项目(201008031)
关键词
膝关节置换术
失血量
深静脉栓塞
Total knee arthroplasty
Blood loss
Deep vein thrombosis
