全髋关节置换术后失血：伤口压迫与引流的前瞻性随机研究。

Blood loss after total hip replacement: a prospective randomized study between wound compression and drainage.

作者信息

Johansson Torsten, Engquist Markus, Pettersson Lars-Göran, Lisander Björn

机构信息

Division of Orthopaedics and Sports Medicine, Department of Neuroscience and Locomotion, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.

出版信息

J Arthroplasty. 2005 Dec;20(8):967-71. doi: 10.1016/j.arth.2005.02.004.

DOI:10.1016/j.arth.2005.02.004

PMID:16376249

Abstract

A randomized, controlled study compared the effects of wound compression with drainage after primary total hip arthroplasty. In 51 patients, an inflatable cuff was placed over the wound underneath a girdle (System Calmed, Calmed AB, Askim, Sweden). Control patients had wound drainage (n = 54). Preoperative and intraoperative variables did not differ between groups. Total blood loss was calculated using hemoglobin balance; with compression it was 1510 +/- 656 mL (mean +/- SD) and in controls 1695 +/- 712 mL (P = .13). However, less blood was transfused in the compression group (P = .05). Wound infection was seen in 2 patients with compression and in 3 controls. Deep venous thrombosis occurred in 3 controls. Wound discharge was more frequent in controls (19/54 vs 8/51; P = .04). Thus, wound compression had no obvious negative effects and reduced wound discharge and need for transfusion. It may replace drainage after total hip arthroplasty.

摘要

一项随机对照研究比较了初次全髋关节置换术后伤口加压与引流的效果。51例患者在伤口上方束带下方放置了一个可充气袖带（System Calmed，Calmed AB，阿斯金，瑞典）。对照组患者进行伤口引流（n = 54）。术前和术中变量在两组之间无差异。使用血红蛋白平衡计算总失血量；加压组为1510±656 mL（均值±标准差），对照组为1695±712 mL（P = 0.13）。然而，加压组的输血次数较少（P = 0.05）。加压组有2例患者发生伤口感染，对照组有3例。3例对照组患者发生深静脉血栓形成。对照组伤口引流更频繁（19/54比8/51；P = 0.04）。因此，伤口加压没有明显的负面影响，减少了伤口引流和输血需求。它可能取代全髋关节置换术后的引流。