下肢关节置换术后应用闭式引流：一项基于 I 级证据的荟萃分析。
Closed suction drainages in Lower Limb Joint Arthroplasty: A level I evidence based meta-analysis.
机构信息
Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany.
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy; School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England, UK; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England, UK.
出版信息
Surgeon. 2022 Jun;20(3):e51-e60. doi: 10.1016/j.surge.2021.02.014. Epub 2022 Jan 29.
INTRODUCTION
The role of closed suction drainage during elective total joint arthroplasty is still unclear. The present study compared the use of closed suction drains to no drainage for elective total knee arthroplasty (TKA) and in total hip arthroplasty (THA) through a meta-analysis of randomized clinical trials (RCTs).
METHODS
Following the PRISMA guidelines, a meta-analysis of randomized controlled trials identified in December 2021. All randomized clinical trials comparing the use of closed suction drains to no drainage for elective THA or TKA were considered.
RESULTS
Twenty-five RCTs were included in the final analysis. 49% (1722 of 3505) of patients received no-drainage, and 51% (1783 of 3505) received closed suction drainage. There was no evidence of a statistically significant evidence between the two groups in occurrence of postoperative infections (P = 0.4), mean total postoperative hemoglobin (P = 0.2) or length of hospital stay (P = 0.1). The no-drainage group showed a lower rate of blood transfusion (P < 0.0001).
CONCLUSION
There is no evidence to support the routine use of closed suction drainage in THA or TKA patients.
LEVEL OF EVIDENCE
Level I, meta-analysis of randomized clinical trials.
简介
在择期全关节置换术中，闭合式吸引引流的作用仍不清楚。本研究通过对随机临床试验（RCT）的荟萃分析，比较了闭合式吸引引流与择期全膝关节置换术（TKA）和全髋关节置换术（THA）中不引流的效果。
方法
根据 PRISMA 指南，对 2021 年 12 月确定的随机对照试验进行荟萃分析。所有比较闭合式吸引引流与择期 THA 或 TKA 中不引流的随机临床试验均被认为是有价值的。
结果
最终分析纳入了 25 项 RCT。49%（1722/3505）的患者未接受引流，51%（1783/3505）的患者接受了闭合式吸引引流。两组在术后感染发生率（P=0.4）、平均总术后血红蛋白（P=0.2）或住院时间（P=0.1）方面均无统计学显著差异。不引流组的输血率较低（P<0.0001）。
结论
没有证据支持在 THA 或 TKA 患者中常规使用闭合式吸引引流。
证据等级
I 级，随机临床试验的荟萃分析。
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