CAJ | 학술논문

目的：明确全膝关节置换（TKA）术后放置引流与加压包扎对术后失血的影响。方法回顾分析天津医科大学总医院滨海医院及天津市人民医院骨关节科2013年1月—2014年1月行初次TKA治疗的内翻型膝关节骨性关节炎患者120例（120膝），男20例，女100例，平均年龄（65.18±6.88）岁。根据是否安置引流将所有患者分为引流组（60例）和加压包扎组（60例）。分析TKA术后血常规变化、失血量和输血情况。结果引流组和加压包扎组TKA术后总体失血量分别为（1026.85±274.44）、（789.52±251.58）mL，加压包扎组低于引流组（t=4.938，P<0.01）。术后异体输血：引流组14例，加压包扎组5例，加压包扎组输血率低于引流组（χ2=5.065，P<0.05）。2组患者术后髌上周径差和关节活动度比较差异均无统计学意义。结论 TKA术中采用伤口加压包扎手术操作简单，能够减少患者围手术期出血、降低异体输血率。
목적：명학전슬관절치환（TKA）술후방치인류여가압포찰대술후실혈적영향。방법회고분석천진의과대학총의원빈해의원급천진시인민의원골관절과2013년1월—2014년1월행초차TKA치료적내번형슬관절골성관절염환자120례（120슬），남20례，녀100례，평균년령（65.18±6.88）세。근거시부안치인류장소유환자분위인류조（60례）화가압포찰조（60례）。분석TKA술후혈상규변화、실혈량화수혈정황。결과인류조화가압포찰조TKA술후총체실혈량분별위（1026.85±274.44）、（789.52±251.58）mL，가압포찰조저우인류조（t=4.938，P<0.01）。술후이체수혈：인류조14례，가압포찰조5례，가압포찰조수혈솔저우인류조（χ2=5.065，P<0.05）。2조환자술후빈상주경차화관절활동도비교차이균무통계학의의。결론 TKA술중채용상구가압포찰수술조작간단，능구감소환자위수술기출혈、강저이체수혈솔。
Objective To compare the efficiency of compressive bandage dressing and drainage on the blood loss after total knee arthroplasty (TKA). Methods Patients (n=120) who visited Tianjin General Hospital Bin Hai Branch and Tianjin People's Hospital due to varus knee osteoarthritis and underwent TKA were retrospectively analyzed.There are 20 males and 100 females with, mean age was 65.18±6.88 years. Depending on whether placement of drainage, patients were divided into drainage group (60 cases) and pressure bandage dressing group (60 cases). Blood loss, blood transfusion and full blood count (FBC) were all analyzed after TKA in both groups. Results Blood loss after TKA in drainage and pressure dressing group were (1 026.85±274.44),(789.52±251.58) mL respectively. Blood loss was less severe in pressure dressing group than that in drainage group (t=4.938, P<0.01). Allogeneic transfusions were needed in 14 cases of drainage group and five cases of pres?sure bandage dressing group. The circumstances that requires blood transfusion was significantly lower in pressure bandage group than that in drainage group (χ2=5.065, P<0.05). The postoperative limb swelling and postoperative joint mobility did not show statistical significance (P>0.05). Conclusion Application of compressive bandage dressing in TKA surgery is easy to be operate and can reduce perioperative blood loss and allogeneic transfusion incidence.