Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Department of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
Int Orthop. 2023 Dec;47(12):2985-2989. doi: 10.1007/s00264-023-05946-z. Epub 2023 Aug 23.
The use of suction drains in total knee arthroplasty (TKA) remains controversial. The aim of this study is to compare the outcomes of patients who received suction drains versus those who did not, focusing on blood loss, blood transfusion need, and length of hospital stay.
A retrospective observational cohort study was conducted at a tertiary hospital between January 1, 2015, and December 30, 2019, and included 262 patients who underwent unilateral non-traumatic primary TKA and were over 18 years old. The Institutional Review Board (IRB) approved the study (MRC-02-20-278).
A total of 262 patients were included, with an age range of 47 to 91 years. Most of the included patients were females, 74.4% (195). Hypertension was the most frequent risk factor, 67.6%, followed by diabetes. Of 262 patients, 156 (59.5%) received a drain. The drain group had significantly longer hospital stay, 30% longer tourniquet time, greater haemoglobin and haematocrit drops, higher count of transfused packed RBC units, and lower use of anticoagulants. Moreover, tranexamic acid (TXA) use (n = 106) in surgery reduced hospital stays, tourniquet time, drain output, and increased pre- and postoperative haemoglobin and hematocrit levels compared to no TXA group (n = 156) (p < 0.05, z-score reported).
This study found that patients who received a drain had longer hospital stays and greater blood loss and transfusion rates compared to those who did not. The use of TXA in surgery was associated with improved outcomes and reduced overall complications.
在全膝关节置换术（TKA）中使用引流管仍然存在争议。本研究旨在比较接受和不接受引流管的患者的结果，重点关注失血量、输血需求和住院时间。
这是一项在 2015 年 1 月 1 日至 2019 年 12 月 30 日在一家三级医院进行的回顾性观察性队列研究，共纳入 262 例接受单侧非创伤性原发性 TKA 且年龄超过 18 岁的患者。机构审查委员会（IRB）批准了该研究（MRC-02-20-278）。
共纳入 262 例患者，年龄 47 至 91 岁。大多数纳入的患者为女性，占 74.4%（195 例）。高血压是最常见的风险因素，占 67.6%，其次是糖尿病。262 例患者中，156 例（59.5%）接受引流。引流组的住院时间明显更长，止血带时间延长 30%，血红蛋白和血细胞比容下降更大，需要输注的浓缩红细胞单位数更高，抗凝剂的使用量更低。此外，与未使用氨甲环酸（TXA）的患者（n=156）相比，手术中使用 TXA（n=106）可缩短住院时间、止血带时间、引流量，并增加术前和术后血红蛋白和血细胞比容水平（p<0.05，报告 z 分数）。
本研究发现，与未接受引流的患者相比，接受引流的患者住院时间更长，失血和输血率更高。手术中使用 TXA 与改善结果和减少整体并发症有关。
