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膝关节置换术和出血:何时拔除引流管。

Knee arthroplasty and bleeding: when to remove drainages.

机构信息

Department of Orthopedic Surgery and Trauma, Hospital Clinic de Barcelona, C/Villarroel 170, Traumatologia, escalera 12-4, 08036, Barcelona, Spain.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2013 Feb;21(2):393-7. doi: 10.1007/s00167-012-1966-x. Epub 2012 Mar 28.

Abstract

PURPOSE

The aim of this study is an attempt to clarify the productive time of drainages as we find that the use of drains in knee arthroplasty is controversial, and there is no consensus regarding their length-time maintenance. We analysed the survival curve of bleeding within three surgical techniques for knee arthroplasty and the effect of two variables on survival curve.

METHODS

One hundred and eighty-eight out of 234 knees were included in the study, and patients were divided into three groups according to the surgical technique: conventional total knee arthroplasty (TKA), subvastus TKA and unicompartmental knee arthroplasty. Variables of study were type of surgery, number and placement of drains.

RESULTS

Mean of survival curve for postoperative bleeding time was 16 h (95 % CI: 15.4; 16.6). The risk for longer bleeding increased 1.38-fold with each additional drain used (95 % CI 1.1; 1.8).

CONCLUSIONS

According to the present study, drains can be safely removed at around 17 h postoperative. Bleeding time reduces as less drains are applied.

LEVEL OF EVIDENCE

Therapeutic study, Level III.

摘要

目的

本研究旨在阐明引流的产生时间,因为我们发现膝关节置换术中使用引流存在争议,并且关于其维持时间长短没有共识。我们分析了三种膝关节置换手术技术的出血生存曲线,以及两个变量对生存曲线的影响。

方法

234 例膝关节中,188 例纳入研究,根据手术技术将患者分为三组:常规全膝关节置换术(TKA)、股四头肌下入路 TKA 和单髁膝关节置换术。研究变量为手术类型、引流管数量和位置。

结果

术后出血时间的生存曲线平均为 16 小时(95%可信区间:15.4; 16.6)。每增加一根引流管,出血时间延长的风险增加 1.38 倍(95%可信区间 1.1; 1.8)。

结论

根据本研究,术后约 17 小时可安全移除引流管。应用的引流管越少,出血时间越短。

证据水平

治疗性研究,III 级。

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