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全膝关节置换术中自体回输的前瞻性随机对照试验

A prospective randomised controlled trial of autologous retransfusion in total knee replacement.

作者信息

Amin A, Watson A, Mangwani J, Nawabi D H, Ahluwalia R, Loeffler M

机构信息

Department of Trauma and Orthopaedics Colchester General Hospital, Turner Road, Colchester, UK.

出版信息

J Bone Joint Surg Br. 2008 Apr;90(4):451-4. doi: 10.1302/0301-620X.90B4.20044.

Abstract

We undertook a prospective randomised controlled trial to investigate the efficacy of autologous retransfusion drains in reducing the need for allogenic blood requirement after unilateral total knee replacement. We also monitored the incidence of post-operative complications. There were 86 patients in the control group, receiving standard care with a vacuum drain, and 92 who received an autologous drain and were retransfused postoperatively. Following serial haemoglobin measurements at 24, 48 and 72 hours, we found no difference in the need for allogenic blood between the two groups (control group 15.1%, retransfusion group 13% (p = 0.439)). The incidence of post-operative complications, such as wound infection, deep-vein thrombosis and chest infection, was also comparable between the groups. There were no adverse reactions associated with the retransfusion of autologous blood. Based on this study, the cost-effectiveness and continued use of autologous drains in total knee replacement should be questioned.

摘要

我们进行了一项前瞻性随机对照试验,以研究自体回输引流在减少单侧全膝关节置换术后异体血需求方面的疗效。我们还监测了术后并发症的发生率。对照组有86例患者,接受使用真空引流管的标准护理,92例患者接受自体引流管并在术后进行回输。在术后24、48和72小时进行系列血红蛋白测量后,我们发现两组之间在异体血需求方面没有差异(对照组为15.1%,回输组为13%(p = 0.439))。两组之间术后并发症的发生率,如伤口感染、深静脉血栓形成和肺部感染,也相当。自体血回输未出现不良反应。基于这项研究,在全膝关节置换术中自体引流管的成本效益及持续使用情况值得质疑。

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