伤口引流管的置放与否在髋关节置换术后快速康复中的对比研究  

Comparative study of placement and no placement of wound drainage tube in rapid recovery after hip replacement

作　　者：屠永刚 任绍东 陈坚 马邦兴 张史飞 袁浩斌 TU Yong-gang;REN Shao-dong;CHEN Jian(The ChangPing Hospital of DongGuan City,Guangdong 523573)

机构地区：[1]东莞市常平医院,广东东莞523573

出　　处：《中国伤残医学》2019年第22期12-13,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:比较髋关节置换术后快速康复中未置放与置放伤口引流管的临床效果.方法:对纳入髋关节置换快速康复的患者61例进行前瞻性分析,随机分为观察组31例(不置放引流管)、对照组30例(置放引流管),术中均予以逐层的彻底止血,氨甲环酸行关节囊周围注射,比较2组患者术后伤口渗血量,髋关节肿胀情况、疼痛程度及有无伤口并发症等,并进行统计学分析.结果:全部患者术后当天下床行走,最早术后1小时,对照组引流管术后24小时-48小时拔除,引流量为30-65ml,中位数为42ml,伤口渗血量为10-60ml,中位数为25ml,其中2例引流管脱落,1例引流管拔出困难,2例引流管口渗液明显,其中1例细菌培养为金黄色葡萄球菌,经敏感抗生素及多次换药后伤口顺利愈合.观察组未置放引流管,伤口渗血量为30-70ml,中位数为45ml,无伤口感染发生.经统计学分析,2组病例术后第1、3、7天患肢髋部周径增加值比较、术后第1、3、7天疼痛VAS评分比较均无统计学意义(P﹥0.05).结论:髋关节置换术中彻底止血、氨甲环酸的局部注射,术后髋部加压包扎及冰敷,未置放引流管可获得满意的临床疗效,更为利于患者的早期功能康复.Objective:To compare the clinical effects of unplaced and placed wound drainage tube during rapid rehabilitation after hip arthroplasty.Methods:A prospective analysis of 61 patients with rapid rehabilitation of hip replacement was performed.The patients were randomly divided into the experimental group(n=31,no drainage tube)and the control group(n=30,drainage tube).During the operation,the patients were completely hemostasis layer by layer,and tranexamic acid was injected around the joint capsule.To compare the postoperative wound bleeding,hip swelling,pain and wound complications,and conduct statistical analysis.Results:All patients walked out of bed on the day after surgery.The drainage tube in the control group was removed 24 h to 48 h after operation.The drainage volume was 30-65 mL,and the wound oozing volume was 10-60 mL with 2 cases of drainage tube falling off,which 1 case of drainage tube was difficult to pull out,2 cases of drainage tube exudate was obvious.The drainage tube was not placed in the experimental group.The wound oozing volume was 30-70 mL with no wound infection.There was no significant difference in the increase of hip circumference diameter and the pain VAC score on the 1st,3rd and 7th day after operation(P>0.05).Conclusion:In the hip arthroplasty,hemostasis,local injection of tranexamic acid,hip compression dressing and ice application could achieve satisfactory clinical results with no drainage tube,which was more conducive to early functional rehabilitation.

关 键 词：引流管的置放 髋关节置换 快速康复 对比研究 

分 类 号：R683.3[医药卫生—骨科学]