摘要
目的:比较两种不同止血带使用方法对人工膝关节置换术早期疗效的影响。方法:选取2017年1月-2018年10月实施人工膝关节置换术患者83例,根据术中止血带的使用方法不同分为两组。A组仅在安装假体时使用止血带;B组手术全程使用止血带。比较两组临床疗效。结果:A组止血带使用时间明显短于B组,差异有统计学意义(P<0.05);A组术中出血量高于B组,差异有统计学意义(P<0.05);A组术后1 d、4 d、7 d血红蛋白水平均高于B组,差异有统计学意义(P<0.05);A组大腿皮肤并发症发生率明显低于B组,差异有统计学意义(P<0.05)。A组术后1 d被动屈曲70°及术后7 d被动屈曲90°时疼痛评分均明显低于B组,差异有统计学意义(P<0.05)。A组术后1 d、4 d、7 d主动关节活动度均优于B组,差异有统计学意义(P<0.05)。结论:膝关节置换术中仅在安装假体时使用止血带,可改善患者术后早期疼痛水平,提高关节活动度,虽术中出血量较多,但围手术期失血量反而更少,利于患肢术后快速康复。
Objective:To compare the effect of two different tourniquet methods on the early curative effect of artificial knee arthroplasty.Methods:From January 2017 to October 2018,83 cases of patients who underwent artificial knee arthroplasty were enrolled,they were divided into two groups according to the methods of using the tourniquet.A group only used tourniquet when fitted with a prosthesis.B group used tourniquet all the time.The therapeutic effects between the two groups was compared.Results:The use time of tourniquet in A group was significantly shorter than that in B group,the difference was statistically significant(P<0.05).A group had more amount of intraoperative bleeding loss than B group,the difference was statistically significant(P<0.05).The levels of hemoglobin after 1 d,4 d and 7 d of operation in A group were higher than those in the B group,the differences were statistically significant(P<0.05).The incidence of thigh skin complications in A group was significantly lower than that in B group,the difference was statistically significant(P<0.05).The pain scores of 70°of passive flexion after 1 d of operation and 90°of passive flexion after 7 d of operation in the A group were significantly lower than those in B group,the differences were statistically significant(P<0.05).The active joint range of motion after 1 d,4 d and 7 d of operation in the A group were better than B group,the differences were statistically significant(P<0.05).Conclusion:The tourniquet is used in knee arthroplasty only when fit with a prosthesis,which can improve the early postoperative pain level and improve joint motion,although the amount of bleeding loss in operation is more,the amount of bleeding loss in perioperative period is less,which is beneficial to the rapid recovery of the affected limb after operation.
作者
冷若琦
李子剑
杨帆
Leng Ruoqi;Li Zijian;Yang Fan(The People's Hospital of Anshun City,Guizhou Anshun 561000;The Third Hospital of Peking University,Beijing 100191)
出处
《中国社区医师》
2021年第9期31-32,共2页
Chinese Community Doctors
关键词
止血带
人工膝关节置换术
疗效
Tourniquet
Artificial knee arthroplasty
Efficacy
