Fagotti Lorenzo, Ejnisman Leandro, Miyahara Helder de Souza, Gurgel Henrique de Melo Campos, Croci Alberto Tesconi, Vicente Jose Ricardo Negreiros
Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Rev Bras Ortop. 2018 Jan 18;53(2):236-243. doi: 10.1016/j.rboe.2018.01.001. eCollection 2018 Mar-Apr.
This study aimed to investigate drain use in a controlled population of patients with hip osteoarthritis undergoing primary total hip arthroplasty.
This prospective controlled trial evaluated 93 patients randomized into two groups: a group that received drains and a group that did not. The patients who were randomized to the drain group used a 3.2 mm drain placed under the fascia that was kept in place for 24 h. Postoperative evaluations were performed after 24 h and then three, six, and 12 weeks after total hip arthroplasty. The primary outcome was perioperative blood loss in both groups 24 h after total hip arthroplasty. The other parameters that were evaluated included mid-thigh circumference, the rate of blood transfusion, hematocrit, inflammatory serum levels, and the Harris Hip Score.
The clinical and laboratory data revealed no differences between the study groups with respect to blood loss and need for blood transfusion, duration of hospital stay, reoperation rate, complications, inflammatory serum markers, and the Harris Hip Score. Patients without closed suction drainage reported higher pain levels after 24 h (VAS score 1 vs. 2, < 0.01).
Similar clinical and laboratory outcomes were found in both cohorts.
本研究旨在调查接受初次全髋关节置换术的髋骨关节炎患者的受控人群中引流管的使用情况。
这项前瞻性对照试验评估了93例随机分为两组的患者:一组接受引流管,另一组不接受。随机分配到引流管组的患者使用一根3.2毫米的引流管置于筋膜下,并保留24小时。全髋关节置换术后24小时以及术后三周、六周和十二周进行术后评估。主要结局是全髋关节置换术后24小时两组的围手术期失血量。评估的其他参数包括大腿中部周长、输血率、血细胞比容、炎症血清水平和Harris髋关节评分。
临床和实验室数据显示,研究组在失血量、输血需求、住院时间、再次手术率、并发症、炎症血清标志物和Harris髋关节评分方面没有差异。未进行闭式吸引引流的患者在24小时后疼痛水平较高(视觉模拟评分1分对2分,<0.01)。
两个队列的临床和实验室结果相似。