膝关节置换术后引流管早期关闭对出血量的影响

目的：研究全膝关节置换术（Total knee arthroplasty,TKA）后两种不同的引流管使用方法对术后患者出血的影响。方法：收集2012年9-12月本科室同一主刀采取膝关节正中入路、沿髌内侧缘切开关节囊术式的病例35例,术后根据不同的引流管开放形式随机分为两组。实验组18例采用术后关闭引流管4h以上,患者自觉胀痛后再予以开放,对照组17例术后引流管处于自然开放引流状态,观察两组术后6、12、24、48h的引流量,术后1、3、5d的体温,切口愈合时间及出院时HSS评分。结果：实验组引流量明显少于对照组,差异具有统计学意义（P〈0.05）。术后各时间点平均体温、切口愈合时间及出院时HSS功能评分两组比较差异无统计学意义（P〉0.05）。结论：全膝关节置换术后先关闭引流管4h以上可明显减少术后出血。

Effect of Temporary Drainage Clamping after Total Knee Arthroplasty

Objective： To observe whether the temporarily-closed （ 4 h ） wound drainage tube is more effective than the conventional drainage after total knee arthoplasty （ TKA ） .Method： 35 casesshu with total knee arthoplasty were randomly divided into observation group and control group. The drainage tube in observation group was closed 4 hours after the surgery while the drainage tube was kept open in control group.The volume of wound drainage 6, 12, 24, 48 h after the surgery was recorded and analyzed.The average temperature in 1, 3, 5 d after the surgery was recorded and analyzed.Result： Average volume of wound drainage in observation groups 6, 12, 24, 48 h after surgery was significantly less than that of control group. No significant differences existed in average temperature, scores of knee joint function and wound eomplications among two groups.Conclusion： Keep tube close for 4 h ean effectively decrease the volume of bleeding.no adverse effects on healing of incision and knee unctional recovery exist after total knee arthoplasty.