全膝置换术是否留置引流管对康复的影响  

Impact of indwelling drainage on rehabilitation in total knee arthroplasty

作　　者：钟宗烨 刘邦忠 张键 陈君 刘圆圆 陆志辉 林岳军 刘光华 ZHONG Zong-ye;LIU Bang-zhong;ZHANG Jian;CHEN Jun;LIU Yuan-yuan;LU Zhi-hui;LIN Yue-jun;LIU Guang-hua(partment of Rehabilitation Medicine,Zhongshan Hospital,Fu-dan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院康复医学科,上海200032

出　　处：《中国矫形外科杂志》2024年第23期2196-2199,共4页Orthopedic Journal of China

基　　金：上海市临床重点专科项目(编号:shslczdzk02703);上海中西医结合康复医学研究所项目(编号:2023XKPT26-RC1)。

摘　　要：【目的】比较全膝置换术(total knee arthroplasty,TKA)后是否留置引流管对膝骨关节炎患者膝功能康复的影响。【方法】回顾性分析2019年7月--2023年1月于本院接受TKA的130例膝骨关节炎患者的临床资料。根据医患沟通结果,65例患者未放置引流管,另外65例放置引流管。比较两组患者围手术期和随访结果。【结果】全部患者均顺利完成手术,无引流组在总失血量【(340.8±101.5)ml vs(389.2±80.8)ml,P=0.049】、术后住院时间【(2.0±0.7)d vs(4.4±0.9)d,P<0.001】显著少于引流组。两组术后并发症发生率的差异无统计学意义(P>0.05)。随时间推移,两组患者疼痛VAS评分均显著减少(P<0.05),膝伸屈ROM、AKSS功能评分均显著增加(P<0.05)。术后1个月,无引流组的VAS评分【(1.7±0.7)vs(2.7±1.0),P=0.002】、膝伸屈ROM【(119.8±4.1)°vs(116.3±6.6)P<0.001】显著优于引流组。【结论】相比留置引流管,全膝置换术后无引流管具有减轻患者术后近期疼痛,缩短住院时间的优势。【Objective】To compare the clinical consequences of total knee arthroplasty(TKA)for knee osteoarthritis(KO)with or without indwelling drainage tube.【Methods】A retrospective study was conducted on 130 patients who received TKA for KO in our hospital from July 2019 to January 2023.According to the results of doctor-patient communication,65 patients had not drainage placed(the ND group),whereas other 65 patients had drainage placed(the D group).The documents regarding to perioperative period and follow-up were compared between the two groups.【Results】All patients in both groups had TKA performed successfully.The ND group proved significantly superior to the D group in terms of total blood loss【(340.8±101.5)ml vs(389.2±80.8)ml,P=0.049】and postoperative hospital stay【(2.0±0.7)days vs(4.4±0.9)days,P<0.001】,although there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).As time went on,the pain VAS scores significantly decreased(P<0.05),while the knee flexion-extension range of motion(ROM)and AKSS scores significantly increased in both groups(P<0.05).The ND group proved significantly better than the D group in terms VAS score【(1.7±0.7)vs(2.7±1.0),P=0.002】,the knee R0M【DHS(119.8±4.1)°vs(116.3±6.6),P<0.001】1 month postoperatively.【Conclusion】Compared with indwelling drainage,no indwelling drainage after total knee arthroplasty has the advantages of reducing short-term postoperative pain and shortening hospital stay.

关 键 词：留置引流管 膝骨关节炎 全膝关节置换术 疼痛 

分 类 号：R687.4[医药卫生—骨科学]