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类风湿关节炎患者全膝关节置换术后引流血回输与临时夹闭引流的疗效比较。

Comparison of therapeutic effects between drainage blood reinfusion and temporary clamping drainage after total knee arthroplasty in patients with rheumatoid arthritis.

机构信息

Department of Orthopedic Surgery, Shengjing Hospital, China Medical University, Shenyang, China.

Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.

出版信息

Clinics (Sao Paulo). 2015 Mar;70(3):202-6. doi: 10.6061/clinics/2015(03)09. Epub 2015 Mar 1.

Abstract

OBJECTIVE

To compare the therapeutic effects between drainage blood reinfusion and temporary clamping drainage after total knee arthroplasty in patients with rheumatoid arthritis to provide a basis for clinical practice.

METHODS

Data from 83 patients with rheumatoid arthritis undergoing total knee arthroplasty were retrospectively analyzed. The 83 patients were divided into a drainage blood reinfusion group (DR group, n = 45) and a temporary clamping drainage group (CD group, n = 38). In the DR group, postoperative drainage blood was used for autotransfusion. In the CD group, closed drainage was adopted, and the drainage tube was clamped for 2 h postoperatively followed by patency. The postoperative drainage amount, hemoglobin level, rate and average volume of allogeneic blood transfusion, swelling and ecchymosis of the affected knee joint, time to straight-leg raising and range of active knee flexion were compared between the two groups.

RESULTS

The total drainage volume was higher in the DR group than in the CD group (P = 0.000). The average volume of postoperative allogeneic blood transfusion (P = 0.000) and the decrease in the hemoglobin level 24 h after total knee arthroplasty (P = 0.012) were lower in the DR group than in the CD group. Swelling and ecchymosis of the affected knee joint, time to straight-leg raising and the range of active knee flexion were improved in the DR group compared with the CD group (all P<0.05).

CONCLUSION

Compared with temporary clamping drainage, drainage blood reinfusion after total knee arthroplasty can reduce the allogeneic blood transfusion volume and is conducive to early rehabilitation in patients with rheumatoid arthritis.

摘要

目的

比较类风湿关节炎患者全膝关节置换术后引流血回输与临时夹闭引流的疗效,为临床实践提供依据。

方法

回顾性分析 83 例类风湿关节炎行全膝关节置换术患者的临床资料,将患者分为引流血回输组(DR 组,n=45)和临时夹闭引流组(CD 组,n=38)。DR 组术后引流血用于自体输血,CD 组采用密闭引流,术后 2 h 夹闭引流管,保持通畅。比较两组术后引流量、血红蛋白水平、异体输血率及平均输血量、患侧膝关节肿胀瘀斑情况、直腿抬高时间及主动屈膝活动度。

结果

DR 组总引流量高于 CD 组(P=0.000),术后异体输血平均量(P=0.000)和全膝关节置换术后 24 h 血红蛋白水平下降量(P=0.012)低于 CD 组。DR 组患侧膝关节肿胀瘀斑、直腿抬高时间及主动屈膝活动度优于 CD 组(均 P<0.05)。

结论

与临时夹闭引流相比,全膝关节置换术后引流血回输可减少异体输血量,有利于类风湿关节炎患者早期康复。

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