全膝关节置换术后关节腔出血动态监测相关研究  

Dynamic monitoring on articular cavity bleeding after total knee arthroplasty

作　　者：阚金庆[1] 李海涛[1] 宋扬[2] 孙培磊 高忠礼[2] 杨玉宝[3] 

机构地区：[1]临沂市人民医院关节外科,276000 [2]吉林大学附属中日联合医院,长春130006 [3]山东高等专科学校附属医院,临沂276000

出　　处：《中华关节外科杂志（电子版）》2015年第1期30-32,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的通过观察全膝关节置换术后6 h关节腔动态出血量,明确其出血规律及其影响。方法选取105例全膝关节置换患者,年龄47~85岁,平均年龄（64.9±8.2）岁。在伸膝状态下动态观测术后6 h内的引流量,测定引流液成分,并统计24 h引流量。结果术后1 h出血量最多,随后以每小时递减一半的速度降低。引流液的红细胞及血红蛋白浓度由3 h内接近全血浓度,转而逐渐降低,其中术后24 h内关节腔引流量为（808.8±286.7）ml。结论全膝置换术后关节腔显性失血主要发生于术后3 h内,术后6 h后引流量显著减少,引流时限6 h可预防关节积血的危害。Objective To observe the hemorrhage in the joint cavity six hours after the total knee arthroplasty（ TKA）,and discuss the pattern and influence of the bleeding. Methods A total of 105 TKA cases were selected,of which the patients were aged from 47 to 85 years,（ 64. 9 ± 8. 2） years in average.After the surgery,the drainage volume was monitored dynamically for six hours while the knee was at the extension position. The composition of the drainage fluid was dermined,and the total drainage volume of 24 hours was recorded. Results The postoperative hemorrhage volume reached the maximum at the 1sthour after the surgery,and then decreased at the speed of a half volume per hour. The concentrations of red blood cells and hemoglobin in the drainage were similar to the whole blood concentration in three hours,and decreased gradually. The 24-hour drainage of the joint cavity after the operation was（ 808. 8 ± 286. 7）ml. Conclusion After TKA,the dominant blood loss in the knee joint cavity occurrs mainly in three hours postoperatively,while the drainage volume significantly reduces six hours after the operation; the drainage should be performed for six hours to prevent hemarthrosis.

关 键 词：关节成形术 置换 膝 引流术 红细胞 血红蛋白类 

分 类 号：R687.4[医药卫生—骨科学]