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[气压止血带在全膝关节置换术中的应用:一项前瞻性随机研究]

[The use of a pneumatic tourniquet in total knee arthroplasty: a prospective, randomized study].

作者信息

Li Bin, Qian Qi-rong, Wu Hai-shan, Zhao Hui, Lin Xiang-bo, Zhu Jun, Weng Wei-feng

机构信息

Department of Orthopaedics, Changzheng Hospital, the Second Military Medical University, Shanghai, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Jul 15;46(14):1054-7.

Abstract

OBJECTIVE

To determine the value of the use of a pneumatic tourniquet in total knee arthroplasty.

METHODS

Sixty patients were prospectively randomized into 2 groups, one group underwent total knee replacement with a tourniquet (n = 30) and one without (n = 30). Operating time, blood loss, postoperative mean morphine requirement, swelling, ecchymosis, earlier straight-leg raising and postoperative knee flexion were measured in both groups.

RESULTS

There was no significant difference in the total blood loss between the 2 groups although the intraoperative blood loss was significantly greater in those without a tourniquet. The mean morphine requirement, postoperative swelling, scope of ecchymosis, earlier straight-leg raising and postoperative knee flexion in the patients that had surgery without a tourniquet were significantly better than those with a tourniquet.

CONCLUSION

Knee arthroplasty operation with the use of a tourniquet has only small benefits on the total blood loss, but hinder in patients' early postoperative rehabilitation exercises.

摘要

目的

确定在全膝关节置换术中使用气动止血带的价值。

方法

前瞻性地将60例患者随机分为2组,一组在止血带下进行全膝关节置换术(n = 30),另一组不使用止血带(n = 30)。测量两组的手术时间、失血量、术后平均吗啡需求量、肿胀、瘀斑、早期直腿抬高和术后膝关节屈曲情况。

结果

两组之间的总失血量无显著差异,尽管未使用止血带的患者术中失血量明显更大。未使用止血带进行手术的患者的平均吗啡需求量、术后肿胀、瘀斑范围、早期直腿抬高和术后膝关节屈曲情况明显优于使用止血带的患者。

结论

在膝关节置换手术中使用止血带对总失血量仅有微小益处,但会阻碍患者术后早期康复锻炼。

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