全膝关节表面置换术中止血带不同使用方法早期临床效果比较.docVIP

全膝关节表面置换术中止血带不同使用方法早期临床效果比较 　作者：闫昌葆，陈百成，赵宝辉，张建彬，董江涛，邢栋，康慧君 【摘要】 ［目的］研究全膝关节表面置换术中止血带不同使用方法对术后早期患者临床症状及患肢功能的影响。［方法］采用随机对照研究方法，对40例骨性关节炎患者行单侧全膝关节表面置换术，其中20例应用全程止血带技术，20例应用中途止血带技术，通过比较两组的出血量、术后临床症状及功能的KSS评分等对2种止血带使用方法的早期临床效果加以评价。［结果］虽然2种止血带技术总的手术出血量差别不显著，但是应用中途止血带技术组患者术后出血量（581±263.9 ml）少于全程止血带技术组（853±295.5 ml），中途止血带组术后伤口红肿天数(3±1.1 d)少于全程止血带组(8±1.3 d)，早期KSS临床评分中途止血带组（55.1±4.9）高于全程止血带组（43.3±5.4）；功能评分中途止血带组（45.0 ±4.4）高于全程止血带组(32.5 ±8.5)。关节血肿发生率及下肢静脉血栓发生率差别不显著。［结论］全膝关节表面置换术中，应用中途止血带技术可以有效减少术后出血，明显改善术后早期临床症状及患肢功能。 【关键词】 全膝关节表面置换术； 止血带； 临床效果 Abstract：［Objective］To evaluate the early clinical effect and affected limb function of patients who underwent total knee arthroplasty (TKA) for different tourniquet technologies.［Method］A randomized study was carried out in 40 patients who received unilateral TKA.Twenty patients received omnidistance tourniquet technology and the other twenty patients received halfway tourniquet technology.The two tourniquet technologies was compared with regard to the volume of blood loss,KSS score of clinical symptoms and function.［Result］The total volume of blood loss of two tourniquet technologies was not different,but the postoperative blood loss of patients who underwent halfway tourniquet technology was less than those who underwent omnidistance tourniquet technology（581±263.9 mllt;853±295.5 ml）.The days of wound reaction were fewer in the halfway turniquet technology group than those who underwent omnidistance tourniquet technology (3±1.1lt;8±1.3) and the KSS score of clinical symptoms（55.1±4.9gt;43.3±5.4）and function （32.5±8.5gt;45.0±5.4）was higher than those who underwent omnidistance tourniquet technology.The incidence rate of hematoma and venous thrombus of lower extremity had no obvious difference.［Conclusion］The postoperative blood loss can be reduced and early postoperative clinical effect and affected limb function can be improved by halfway tourniquet technology for patients who underwent TKA. Key words：total knee arthroplasty; tourn