【摘要】 目的:探索膝关节置换术中止血带的最佳使用方法。方法:收集自2005年3月～2012年3月98例在我院行全膝关节置换手术患者的临床资料,根据术中止血带使用方法随机分为A组(n=41)和B组(n=57)2组,A组只在截骨和安装假体时使用,于假体安装前骨床准备时开始使用止血带,假体安装完成、骨水泥固化后放开止血带并进行止血;B组则全程使用止血带,在关闭切口,加压包扎后放松止血带。比较2组患者的手术时间、止血带使用时间、术中失血、术后引流、总失血量以及术后血栓形成和感染等并发症的发生率。结果:2组在手术时间和术中失血量方面无显著差异;A组的术后引流量、总失血量和术后并发症的发生率低于B组,差异有统计学意义。结论:全膝关节置换术中,在截骨和骨水泥固化过程中使用止血带的方法不仅能减少手术总的失血量,提供良好的假体安装术野和骨水泥固化条件,而且不增加DVT和感染的发生率,对提高手术质量、改善预后有重要意义。更多还原

【Abstract】 Objective: To explore the best method of tourniquet application in total knee arthroplasty. Methods: The clinic datas of 98patients with total knee arthroplasty were collected in our hospital from Mar 2005 to Mar 2008. They were divided into A group( n = 41)and B group( n = 57) at random,according to the method of tourniquet application. A group was operated with tourniquet- working during osteotomy and bone cement solidification and with tourniquet release and hemostasis before wound closure,and B group was operated with tourniquet release after wound closure and pressure dressing. The tourniquet time,perioperative blood loss and the incidence of complications,including infection and thrombosis,were observed. Results: There were no difference in the operation time and amount of intraoperative blood loss between two groups( P > 0. 05). The amount of postoperative drainage,total blood loss and complications was been significantly decreased in A group than in B group( P < 0. 05). Conclusion: The method of tourniquet- working during osteotomy and bone cement solidification not only could provide good prosthesis installation operation field and bone cement solidification conditions,but also decrease perioperative blood loss and the risk of postoperative complication. It’s significant to improve the operation quality and prognosis for TKA operation.更多还原