摘要
背景:全髋关节置换后放置引流管的目的在于引流出髋部积聚的血液,以加速患者康复。但由于术中已静脉滴入氨甲环酸,并可产生确切的减少失血的效果,术后常规放置引流管是否仍有必要?目的:探讨在全髋关节置换术中静滴氨甲环酸止血的基础上术后是否需要放置引流管。方法:选择2017年6月至2019年3月山西医科大学第二医院收治的初次单侧全髋关节置换患者132例,术中均静脉滴注氨甲环酸,其中62例全髋关节置换后放置引流管(引流组),70例全髋关节置换后不放置引流管(无引流组)。比较两组术后失血量、输血率、输血量、血红蛋白值及并发症发生情况;比较术后两组患者平均住院时间;术后随访髋关节Harris评分。试验获得山西医科大学第二医院伦理委员会批准。结果与结论:①两组术后失血量、输血率、输血量与血红蛋白值比较差异均无显著性意义(P>0.05);②引流组4例发生双下肢深静脉血栓,无引流组2例发生双下肢深静脉血栓,组间比较差异无显著性意义(P>0.05);③引流组出现了3例渗血渗液、3例感染、2例肿胀瘀斑,无引流组出现了1例渗血渗液、1例肿胀瘀斑,两组切口并发症比较差异有显著性意义(P<0.05);④引流组平均住院时间长于无引流组(P<0.05);⑤两组术后1,3,6个月的髋关节Harris评分比较差异均无显著性意义(P>0.05);⑥结果表明,全髋关节置换术中静滴止血药物氨甲环酸后无需进行引流管放置。
BACKGROUND:The purpose of placing drainage tube after total hip arthroplasty is to drain the accumulated blood in the hip,so as to accelerate the recovery of patients.However,since tranexamic acid has been infused intravenously during the operation,and the effect of blood loss can be reduced exactly.It remains poorly understood that whether it is necessary to place a drainage tube routinely after the operation.OBJECTIVE:To investigate whether the drainage tube should be placed on the basis of hemostasis by intravenous drip of tranexamic acid in total hip arthroplasty.METHODS:From June 2017 to March 2019,132 patients with primary unilateral total hip arthroplasty admitted to the Second Hospital of Shanxi Medical University were selected.During the operation,tranexamic acid was infused intravenously.Drainage tube was placed in 62 patients(drainage group)after total hip arthroplasty,and not placed in 70 patients(non-drainage group).The blood loss,blood transfusion rate,blood transfusion volume,hemoglobin value and complications were compared between the two groups.The average hospital stay of the two groups was compared.Harris score of hip joint was followed up after operation.The experiment was approved by the Ethics Committee of the Second Hospital of Shanxi Medical University.RESULTS AND CONCLUSION:(1)There was no significant difference in blood loss,blood transfusion rate,blood transfusion volume,and hemoglobin value between the two groups(P>0.05).(2)There was no significant difference in deep vein thrombosis of both lower limbs between the drainage group(four cases)and the non-drainage group(two cases)(P>0.05).(3)There were three cases of bleeding,three cases of infection,two cases of swelling and ecchymosis in the drainage group,and one case of bleeding and one case of swelling and ecchymosis in the non-drainage group.There were significant differences in incision complications between the two groups(P<0.05).(4)Average hospital stay was longer in the drainage group than in the non-drainage group(P<0.05).(5)The
作者
王望任
石俊俊
黄凌岸
张志强
Wang Wangren;Shi Junjun;Huang Lingan;Zhang Zhiqiang(Department of Orthopedics,Second Hospital of Shanxi Medical University,Taiyuan 030000,Shanxi Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第30期4789-4794,共6页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金青年基金(31300802),项目负责人:石俊俊。
关键词
骨
关节
假体
氨甲环酸
失血
输血
切口并发症
髋关节功能
bone
joint
prosthesis
tranexamic acid
blood loss
blood transfusion
incision complications
hip function
