Effects of early drainage tube occlusion on blood loss after total knee arthroplasty
10.3969/j.issn.2095-4344.2016.13.004
- VernacularTitle:全膝关节置换后早期夹闭引流管对失血量的影响
- Author:
Zhiqiang FU
;
Changsuo XIA
;
Zhijie LI
;
Tao JIANG
;
Cailong ZHANG
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2016;20(13):1852-1858
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Artificial knee joint replacement in older patients often combines with basic diseases, such as hypertension and diabetes. Perioperative blood loss is an important factor affecting the safety of replacement. OBJECTIVE: To explore the effect of the early closure of drainage tube on blood loss after primary total knee arthroplasty. METHODS: We randomly selected 90 patients with osteoarthritis of the knee who underwent primary total knee arthroplasty in the Affiliated Hospital of Qingdao University from January 2014 to July 2015. The patients were randomly divided into three groups (n=30). In the 4-hour occlusion group, the drainage tube was closed for 4 hours in early stage of replacement. In the 2-hour occlusion group, the drainage tube was closed for 2 hours in early stage of replacement. In the control group, the drainage tube was not closed. Because of the use of tourniquet during surgery, the amount of intraoperative blood loss was considered as 0 mL. Drainage blood loss after surgery was recorded. Total blood loss was calculated according to Gross formula through patient height, weight and preoperative and postoperative hematocrit. Hidden blood loss was gotten by subtracting the visible blood loss from total loss. Under the observation of postoperative joint sweling and subcutaneous ecchymosis, knee Hospital for Special Surgery score was recorded at 6 weeks after replacement, and compared among groups. RESULTS AND CONCLUSION:Statistical analysis indicated that significant differences in total blood loss and dominant blood loss were detected among the three groups (P < 0.05), indicating that both occlusion for 2 hours and 4 hours could reduce total blood loss and dominant blood loss, but the range of reduction was greater in occlusion for 4 hours. At 6 months after replacement, no significant difference in knee Hospital for Special Surgery score and hidden blood loss was detectable among three groups (P > 0.05). The incidence of joint sweling and subcutaneous ecchymosis was increased in the 4-hour occlusion group (P < 0.05). Above results confirmed that drainage tube occlusion can decrease total blood loss and dominant blood loss after total knee arthroplasty, but cannot reduce hidden blood loss. 2-hour occlusion after total knee arthroplasty is an ideal choice, but the amount of hidden blood loss should be carefuly considered.
