Cao Li, Ablimit Nijat, Mamtimin Askar, Zhang Ke-yuan, Li Guo-qing, Li Gang, Peng Li-bin
Department of Orthopaedic Surgery, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China.
Zhonghua Wai Ke Za Zhi. 2009 Sep 15;47(18):1390-3.
To prospectively compare of no drain or with drain after unilateral total knee arthroplasty (TKA).
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.
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.
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.
前瞻性比较单侧全膝关节置换术(TKA)后不放置引流管与放置引流管的情况。
在2006年2月至2007年2月期间进行了一项随机前瞻性研究。该研究纳入了100例患者,分为两组:A组(n = 50),包括未进行引流管放置的患者;B组(n = 50),包括进行了引流管放置的患者。根据身高、体重以及术前和术后的血细胞比容计算实际总失血量,并通过总失血量减去可见失血量得出隐性失血量。比较并分析术后恢复情况、相关并发症及输血量。
所有100例行TKA的患者均纳入结果分析。未放置引流管的患者,总失血量为(535±295)ml,隐性失血量为(513±290)ml;放置引流管的患者,总失血量为(853±331)ml,隐性失血量为(689±324)ml。引流管组与未放置引流管组之间的总失血量、隐性失血量及输血量差异有统计学意义(P < 0.05)。感染发生率、术后恢复及相关并发症的差异未达到统计学意义。
在初次行TKA的患者中,与不使用引流管相比,使用引流管并未显示出明显优势。不放置引流管可能是一种减少单侧TKA患者失血量及预防输血的有效且经济的方法。