CAJ | 학술논문

背景：通常评价关节置换患者出血量主要是记录置换中的出血量和置换后的引流量，这些只是显性失血量，研究表明隐性失血量可达到并超过总量的50%。 　　目的：比较全膝关节置换高负压引流和普通负压引流失血量，评价高负压引流对全膝关节置换隐性失血的影响。 　　方法：60例单侧全膝人工关节置换患者根据置换后采用的负压吸引不同分为高负压引流组和普通负压引流组(对照组)，每组30例。通过Gross方程推算，对膝关节置换后总失血量(显性失血量+隐性失血最)和输血量进行分析，并对两组置换后并发症及功能恢复状况进行比较。 　　结果与结论：高负压引流组患者总失血量为(646±184) mL，隐性失血量为(215±128) mL；对照组患者总失血量为(867±296) mL，隐性失血量(457±268) mL；高负压引流组总失血量及隐性失血量均明显少于对照组(P<0.05)。高负压引流组平均输血量224 mL，对照组平均输血量467 mL。单侧全膝关节置换后采用高负压引流，总失血量、隐性失血量及置换后输血量均少于对照组，尤其是隐性失血量的减少，有利于病情的观察、处理，规避潜在的风险，有利于置换后膝关节功能的恢复。
배경：통상평개관절치환환자출혈량주요시기록치환중적출혈량화치환후적인류량，저사지시현성실혈량，연구표명은성실혈량가체도병초과총량적50%。 　　목적：비교전슬관절치환고부압인류화보통부압인류실혈량，평개고부압인류대전슬관절치환은성실혈적영향。 　　방법：60례단측전슬인공관절치환환자근거치환후채용적부압흡인불동분위고부압인류조화보통부압인류조(대조조)，매조30례。통과Gross방정추산，대슬관절치환후총실혈량(현성실혈량+은성실혈최)화수혈량진행분석，병대량조치환후병발증급공능회복상황진행비교。 　　결과여결론：고부압인류조환자총실혈량위(646±184) mL，은성실혈량위(215±128) mL；대조조환자총실혈량위(867±296) mL，은성실혈량(457±268) mL；고부압인류조총실혈량급은성실혈량균명현소우대조조(P<0.05)。고부압인류조평균수혈량224 mL，대조조평균수혈량467 mL。단측전슬관절치환후채용고부압인류，총실혈량、은성실혈량급치환후수혈량균소우대조조，우기시은성실혈량적감소，유리우병정적관찰、처리，규피잠재적풍험，유리우치환후슬관절공능적회복。
BACKGROUND:Usual y, amount of bleeding during replacement and drainage amount after replacement were recorded to evaluate the amount of bleeding in patients with arthroplasty. These are dominant blood loss. Studies demonstrated that recessive blood loss exceeded 50%of total amount. OBJECTIVE:To compare the blood loss during total knee arthroplasty under high negative pressure drainage and common negative pressure drainage and to assess the effect of high negative pressure drainage on hidden blood loss in total knee arthroplasty. METHODS:A total of 60 patients undergoing lateral total knee arthroplasty were equal y divided into high negative pressure drainage group and conventional drainage group (control group). We calculated the total blood loss (dominant blood loss and hidden blood loss) and blood transfusion amount with the Gross equation. The recovery after surgery and complications were compared. RESULTS AND CONCLUSION:In high negative pressure drainage group, the total blood loss was (646±184) mL and the hidden blood loss was (215±128) mL. In the control group, the total blood loss was (867±296) mL and the hidden blood loss was (457±268) mL. The total blood loss and hidden blood loss in the high negative pressure drainage group were significantly less than those in the control group (P<0.05). The average blood transfusion amount was 224 mL in the high negative pressure drainage group and 467 mL in the control group. Fol owing unilateral total knee arthroplasty, total blood loss, hidden blood loss and blood transfusion amount after arthroplasty were less in the high negative pressure drainage group than those in the control group. In particular, the decrease in hidden blood loss was helpful to observe and treat the pathogenetic condition and to avoid potential risk, and benefits the recovery of knee joint function after surgery.