Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China.
Int Orthop. 2014 Feb;38(2):355-9. doi: 10.1007/s00264-013-2177-x. Epub 2013 Nov 21.
The aim of this study was to explore the influence of a half-course tourniquet strategy on the peri-operative blood loss and early functional recovery in primary total knee arthroplasty.
A prospective clinical randomised controlled study was carried out in which 64 patients were equally divided into two groups: half-course group and whole-course group. A series of indicators were observed and recorded. These included operation time, peri-operative blood loss, visual analogue scale (VAS) score of the thigh or knee, limb swelling index, rehabilitation progress and occurrence of deep venous thrombosis cases.
There was no significant difference in operation time between the two groups. The intra-operative blood loss was slightly more in the half-course group, while the difference was not significant. The post-operative blood loss and calculated blood loss were less in the half-course group and the difference was significant. The thigh VAS score, limb swelling and time intervals required for patients to achieve straight leg raises and 90° of knee flexion in the half-course group were better than in the whole-course group. No case of symptomatic deep venous thrombosis happened in this study, while occult incidence of deep venous thrombosis happened in both groups, but no significant difference between the groups was confirmed.
The half-course tourniquet strategy could decrease the total peri-operative blood loss in primary total knee arthroplasty. It was beneficial in helping patients to achieve earlier functional recovery by improving the pain experience and limb swelling early in the post-operative period.
本研究旨在探讨半程止血带策略对初次全膝关节置换术围手术期失血和早期功能恢复的影响。
前瞻性临床随机对照研究，将 64 例患者等分为半程组和全程组。观察和记录一系列指标，包括手术时间、围手术期失血、大腿或膝关节的视觉模拟评分（VAS）、肢体肿胀指数、康复进展和深静脉血栓形成病例的发生情况。
两组手术时间无显著差异。半程组术中出血量略多，但差异无统计学意义。半程组术后失血量和计算失血量较少，差异有统计学意义。半程组大腿 VAS 评分、肢体肿胀以及患者实现直腿抬高和膝关节屈曲 90°所需的时间间隔均优于全程组。本研究中无症状性深静脉血栓形成病例发生，两组均有隐匿性深静脉血栓形成病例发生，但组间无显著差异。
初次全膝关节置换术中采用半程止血带策略可减少总围手术期失血。通过改善术后早期疼痛体验和肢体肿胀，有助于患者更早地恢复功能。
