Marulanda German A, Krebs Victor E, Bierbaum Benjamin E, Goldberg Victor M, Ries Michael, Ulrich Slif D, Seyler Thorsten M, Mont Michael A
Department of Orthopaedics and Sports Medicine, University of South Florida, Tampa, FL 33613, USA.
Am J Orthop (Belle Mead NJ). 2009 Dec;38(12):E179-83.
Previous studies have shown that, compared with standard electrocautery, a bipolar sealer reduces tissue damage and smoke production during surgery. We conducted a multicenter, prospective, randomized study to compare a bipolar sealer with standard electrocautery for hemostasis. Sixty-nine primary total knee arthroplasties were performed. Cohorts were evaluated for intraoperative and postoperative blood loss, blood transfusion requirements, postoperative hemoglobin and pain levels, length of hospital stay, range of motion, and Knee Society scores. Amount of blood loss and decrease in postoperative hemoglobin were significantly lower in the bipolar sealer group than in the standard electrocautery group. Need for autologous blood transfusions was decreased in the bipolar sealer group compared with the electrocautery group. There were no between-groups differences in clinical knee scores. The bipolar sealer was an effective coagulation alternative for total knee arthroplasties in reducing blood loss and transfusion requirements without affecting clinical outcome.
以往研究表明，与标准电灼术相比，双极电凝器在手术过程中可减少组织损伤和烟雾产生。我们进行了一项多中心、前瞻性、随机研究，比较双极电凝器与标准电灼术用于止血的效果。共进行了69例初次全膝关节置换术。对各队列的术中及术后失血量、输血需求、术后血红蛋白水平和疼痛程度、住院时间、活动范围以及膝关节协会评分进行了评估。双极电凝器组的失血量和术后血红蛋白降低幅度显著低于标准电灼术组。与电灼术组相比，双极电凝器组的自体输血需求有所减少。两组的临床膝关节评分无差异。双极电凝器是全膝关节置换术中一种有效的凝血替代方法，可减少失血量和输血需求，且不影响临床结果。
