McNally M A, Bahadur R, Cooke E A, Mollan R A
Department of Orthopaedic Surgery, The Queen's University of Belfast, Musgrave Park Hospital, Belfast, Northern Ireland.
J Bone Joint Surg Br. 1997 Jul;79(4):633-7.
We studied the effect of total knee replacement on venous flow in 110 patients. Resting venous blood flow was measured using strain-gauge plethysmography before operation, after surgery and after discharge from hospital. There was a significant reduction in mean venous capacitance (p < 0.001) and mean venous outflow (p < 0.004) affecting only the operated leg. Both improved significantly after mobilisation in the early postoperative period, returning to preoperative levels by six days after surgery and before discharge from hospital. Our findings showed that venous stasis may contribute to deep-vein thrombosis only in the first few days after total knee replacement. This would be the most important period for the use of flow-enhancing prophylactic devices. Comparison with changes in blood flow after total hip replacement identified different patterns of altered haemodynamics suggesting that there are different mechanisms of venous stasis and thrombogenesis in hip and knee arthritis and during surgery for these conditions.
我们研究了全膝关节置换术对110例患者静脉血流的影响。在手术前、术后及出院后，使用应变片体积描记法测量静息静脉血流。平均静脉容量（p < 0.001）和平均静脉流出量（p < 0.004）显著降低，且仅影响手术侧下肢。术后早期活动后两者均显著改善，术后6天及出院前恢复至术前水平。我们的研究结果表明，静脉淤滞可能仅在全膝关节置换术后的最初几天导致深静脉血栓形成。这将是使用促进血流的预防性装置的最重要时期。与全髋关节置换术后血流变化的比较确定了血流动力学改变的不同模式，表明髋关节炎和膝关节炎以及这些疾病手术期间存在不同的静脉淤滞和血栓形成机制。
