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投稿时间：2019-09-25 网络发布日期：2020-05-20
投稿时间：2019-09-25 网络发布日期：2020-05-20
中文摘要: 目的 研究人工全膝关节置换术(TKA)术后放置与不放置引流管对术后快速康复的影响。方法 采用回顾性研究方法,选取2018年5月1日至2019年4月31日在宁夏医科大学总医院行单侧TKA的106例患者为研究对象,其中58例术后常规放置1根引流管,设为对照组;48例术后未放置引流管,作为观察组。分析比较两组患者在术后1 d、术后1周的血红蛋白(Hb)、红细胞比容(Hct)值差异及患侧大腿肿胀情况,评估两组术后1周、1个月的视觉模拟评分(VAS)及膝关节功能(HSS)评分,统计两组术后1个月并发症发生率。结果 两组术后1 d的Hb、Hct水平、术后大腿肿胀率、术后VAS评分比较差异无统计学意义(P>0.05)。与对照组比较,观察组术后1周Hb［(121.40±10.05)g/Lvs(117.47±10.61)g/L,P=0.041］、Hct［(33.53±5.82)%vs(31.09±4.57)%,P=0.047］明显增高,术后1周、1个月膝关节HSS评分明显增高(P=0.032,P=0.048)。观察组术后发热率高于对照组(33.33%vs13.79%,P=0.017);其他并发症发生率两组间无统计学差异(P>0.05)。结论 TKA术后不放置引流可减少患者术后隐性失血,且有益于患者早期功能锻炼,恢复膝关节活动度,对术后并发症发生率也未有较大影响,符合快速康复理念。
Abstract:ObjectiveTo study the effects of drainage tube placement or non-placement on rehabilitation after total knee arthroplasty (TKA) in enhanced recovery after surgery (ERAS).MethodsA retrospective study was conducted on 106 patients undergoing unilateral TKA from May 2018 to April 2019.There were 58 cases with one drainage tube placed after TKA (control group) and 48 cases without drainage tube placed after TKA (observation group).The levels of hemoglobin (HB),hematocrit (HCT) and the swelling of affected thighs were compared at 1 day and 1 week after operation between two groups.Visual analogue score (VAS) and Hospital for special surgery (HSS) knee score were evaluated at 1 week and 1 month after operation,and the incidences of complications were observed at 1 month after operation in two groups.ResultsThere were no significant differences in Hb and HCT levels,thigh swelling rate and VAS score between two groups (P>[JP2]0.05).Compared with control group,Hb［(121.40±10.05) g/L vs (117.47±10.61) g /L,P=0.041］,HCT［(33.53±5.82)%[JP] vs (31.09±4.57)%,P=0.047］ significantly increased at one week after operation,and HSS scores increased at one week (P=0.032) and one month (P=0.048) after operation in observation group.The postoperative fever rate in observation group was statistically higher than that in control group (33.33% vs 13.79%,P=0.017),and there was no significant difference in the incidence of other complications between two groups (P>0.05).ConclusionNo drainage after TKA can reduce the postoperative recessive blood loss and is beneficial to early functional exercise and rapid recovery of knee joint activity,and it has no significant impact on the incidence of postoperative complications.
keywords: Enhanced recovery after surgery Total knee arthroplasty Postoperative drainage Visual analogue score Hospital for special surgery knee score Hemoglobin Hematocrit
文章编号： 中图分类号： 文献标志码：B
基金项目:国家自然科学基金(81760405);宁夏自然科学基金重点项目(2018AAC02013);宁夏医科大学校级课题重点项目(XZ2018014)
引用文本：
张晨,李永宁,宋国瑞,等.快速康复外科理念中不放置引流管对人工全膝关节置换术后康复的影响[J].中国临床研究,2020,33(5):619-622.
张晨,李永宁,宋国瑞,等.快速康复外科理念中不放置引流管对人工全膝关节置换术后康复的影响[J].中国临床研究,2020,33(5):619-622.