全膝关节置换术中止血带使用方法对围手术期失血量及术后早期并发症的影响  

Effects of different tourniquet methods on perioperative blood loss and early postoperative complications in total knee arthroplasty

作　　者：段国庆[1] 任春凤[2] 

机构地区：[1]济宁医学院附属医院骨关节科,山东省济宁市272029 [2]山东省济宁市第一人民医院风湿免疫科

出　　处：《中国骨与关节损伤杂志》2014年第8期779-781,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨不同止血带使用方法在全膝关节置换(TKA)术中对围手术期失血量及术后早期并发症的影响。方法行单侧TKA的100例膝关节骨性关节炎,随机分成全程组(手术开始至假体安装完成使用止血带)和短时组(术中截骨完成后至假体安装完成使用止血带),记录2组手术时间、使用止血带时间、肢体肿胀程度、围手术期总失血量、输血率、术后是否能主动直腿抬高、有无大腿疼痛,比较2组间的差异。结果 2组间围手术期总失血量差异无统计学意义(P=0.380);短时组输血率明显低于全程组(P<0.001);短时组术后早期并发症的发生率较全程组明显降低(P<0.001)。结论TKA术中短时应用止血带并未增加围手术期总失血量,可降低输血率以及术后早期并发症的发生率,有利于患者术后早期康复。Objective To explore the effects of different tourniquet methods on perioperative blood loss and early postoperative complications in total knee arthroplasty （TKA）. Methods One hundred patients with knee osteoarthritis were treated with primary unilateral TKA. They were randomly divided into two equal groups. In fun-course group, the tourniquet was used when the procedure starting and released before suturing. In short.--time group, it was used when the osteotomy was inserted and the prosthesis was installated. Operating time, tourniquet time, perioperative total blood loss, transfusion rate, swelling of lower limbs, straight leg raising, the thigh pain were compared. Results There were no difference in perioperative blood loss between two groups （P =0.380）. Short-time tourniquet technology reduced the transfusion rate （P 〈0.001）. Besides short-time tourniquet technology had less early postoperative complications （P 〈0.001）. Conclusion Short-time tourniquet technology doesn＇t change the perioperative blood loss, but can reduce the transfusion rate and improve early postoperative rehabilitation exercise for patients who underwent TKA.

关 键 词：全膝关节置换术 止血带 围术期 失血量 并发症 

分 类 号：R687.42[医药卫生—骨科学]