单侧全膝人工关节置换术后引流选择的随机对照研究

目的 比较单侧全膝人工关节置换术后引流与否的差异.方法 2006年2月至2007年2月100例单侧全膝人工关节置换术患者随机分为未引流组和引流组(对照组),每组50例,进行前瞻性研究.通过Gross方程推算,对术后总失血量(显性失血量+隐性失血量)和输血量进行分析;并对两组术后并发症及功能恢复状况进行比较.结果 引流组患者总失血量为(535±295)ml,隐性失血量为(513±290)ml;对照组患者总失血量为(853±331)ml,隐性失血量(689±324)ml;未引流组总失血量明显少于对照组(t=5.4611,P<0.05).未引流组患者术后输血量为(112±226)ml,对照组(316±283)ml,未引流组明显少于对照组(t=3.9852,P<0.05).术后输血人次未引流组为11例,对照组为32例,未引流组输血率明显低于对照组(未校正χ~2=18,P<0.05).两组间术后并发症的发生率及功能恢复差异无统计学意义(P>0.05).结论 单侧全膝人工全膝关节置换术术后不放引流组无论总失血量,还是术后输血量均少于对照组,且输血率低.两组术后并发症的发生率及术后膝关节功能恢复无明显差异.

Comparison of no drain or with a drain after unilateral total knee arthroplasty: A prospective randomized controlled trial

Objective To prospectively compare of no drain or with drain after unilateral total knee arthroplasty (TKA). Methods A randomized prospective study was conducted between February 2006 and February 2007. The study included 100 patients who were divided into 2 groups: group A (n =50), which included patients without drain release, and group B (n = 50), which included patients who had a drain release. The true total blood loss was calculated depending on the height, body mass and pre-and post-operative Hct, and hidden blood loss was gotten by subtracting the visible blood loss from total loss. The recovery after surgery, the correlative complications and transfusion amounts were compared and analyzed. Results All 100 patients undergoing TKA were involved in the result analysis. In patients without a drain, the total blood loss was (535±295) ml and the hidden blood loss was (513±290) ml, in patients with a drain, the total blood loss was (853 ± 331) ml and the hidden blood loss (689 ± 324) ml. The total and hidden blood loss, blood transfusion amount between drain-group and without drain-group was significantly different (P < 0.05). The difference in the incidence of infection and post-op recovery and correlative complications did not reach statistical significance. Conclusions In patients having primary TKA, using a drain, compared with no use of a drain , does not show us a clear advantage that make us accept it. Without a drain release could present an effective and economic method for reducing blood loss and preventing blood transfusion in patients undergoing unilateral TKA.