初次全膝关节置换术后下肢体位对术后失血及关节活动度影响研究.docVIP

初次全膝关节置换术后下肢体位对术后失血及关节活动度的影响研究 　　【摘要】 目的：初步探索初次全膝关节置换术后不同体位对术后失血及关节活动度的影响。方法：选择2013年1月-2015年6月100例因膝关节骨关节炎于本院行初次全膝关节置换术患者作为研究对象，根据术后体位分为屈曲组及伸直组。屈曲组患者术后下肢抬高45°、膝关节屈曲45°并维持48 h；伸直组维持膝关节伸直位。比较两组围手术期总失血量、隐性失血量、术后6周膝关节活动度、术后血红蛋白水平、输血情况及并发症发生情况。结果：屈曲组总失血量及隐性失血量均少于伸直组，比较差异均有统计学意义（P0.05）。两组术后48 h内输血患者例数及浅表感染发生率比较，差异均无统计学意义（P0.05）；屈曲组平均住院时间短于伸直组，比较差异有统计学意义（P=0.00）；两组均无DVT发生。结论：初次全膝关节置换术后下肢抬高45°、膝关节屈曲45°并维持48 h可明显减少围手术期失血，增加关节活动度。 　　【关键词】 全膝关节置换术； 失血； 关节活动度； 膝关节体位 　　Influence Study of Postoperative Knee Position on Blood Loss and Range of Motion after Primary Total Knee Arthroplasty/ZENG Yong-ji，LIAO Lian-mei，DING Hong.//Medical Innovation of China，2016，13（10）：146-148 　　【Abstract】 Objective： To assess the effect of postoperative knee position on blood loss and range of motion during primary total knee arthroplasty（TKA）.Method：100 patients undergoing primary TKA for degenerative osteoarthritis in our hospital from January 2013 to June 2015 were selected as the research objects.They were divided into flexion group and extension group according to their postoperative position.In the flexion group，the affected leg was elevated postoperatively by 45°，with 45° flexion at the knee，maintain 48 hours，while patients in the extension group had the knee extended fully.The total blood loss，hidden blood loss，range of motion at six weeks，postoperative hemoglobin level，length of hospital stay，situation of blood transfusion and incidence of complications were compared between the two groups.Result：The total blood loss and hidden blood loss of the flexion group were less than those of the extension group，the differences were statistically significant（P0.001）. 　　48 hours after operation，patients in flexion group gained higher hemoglobin level than patients in the extension group，the difference was statistically significant（P0.05）.The differences in the number of patients with blood transfusion 48 hours after operation and the incidence rate of superficial infection between the two groups