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ID:34189864
大小:2.37 MB
页数:33页
时间:2019-03-04
《全膝关节置换术后患肢不同体位对术后出血的影响研究》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、全膝关节置换术后患肢不同体位对术后出血的影响研究摘要目的探讨减少全膝关节置换(TKA)术后出血的相对更有效的患肢体位。方法按随机数字表法将2010/9/5至2012/7/15入住本周并符合试验要求的患者分三组。A组(68例):患肢髋关节及膝关节伸直位;B组(65例):患肢髋关节屈曲抬高45。,膝关节屈曲70。;C组(73例):患肢髋关节屈曲抬高45。,膝关节伸直位。试验干预于术后12h终止,术后3组均放置负压引流袋24h,比较各组24h引流量及手术前后的血红蛋白(Hb)差值,并对比术后5天膝关节活动度。结果术后24h引流量:A组为(424.76-4-59.11)ml,B组为(40
2、3.71士56.26)ml,C组为(404.154-51.89)ml,三组间差异有统计学意义(P0.05)。手术前后Hb差值:A组为(33.09a:7.03)g/L,B组为(29.924-5.33)g/L,C组为(30.68-4-6.28)g/L,三组间差异有统计学意义(尸o.05)。三组术后5d膝关节活动度差异比较无统计学意义(JP>0.05)。B组术后4d发生深静
3、脉血栓1例。结论屈靛位与髓关节伸直位相比可减少TKA术后出血量;相同屈髋角度时,屈膝70。位和直腿抬高位对减少TKA术后出血的作用相同。同时鉴于大角度屈膝时对切口的不良影响,作者推荐术后将患肢直腿抬高以减少TKA术后出血。硕士研究生:胡百强(骨外科)导师:孙康教授关键词:膝关节置换术;术后出血;体位Effectofthreekindsoflimbpositiononbloodlossposttotalkneearthroplasty—arandomizedcontrolledtriaAbstractobjectiveToaddresstherelativelymoreeffect
4、ivelimbpositiononreducingpostoperativebloodlossoftotalkneearthroplasty(TI5、ents):theirhipwasplacedin4500felevation,andkneein70。offlexion;groupC(73patients):theirhipWasplacedin4500felevationwithkneeinextension.Alltheaboveinterventionslastedfor12hpostoperatively.Thewounddrainagewithnegativepressurewasremoved24hoursaftersurgeryinallgroups.The24hdrainagevolumeandthediff6、erencebetweenpreoperativeandpostoperativehemoglobin(Hb)werecompared.Rangeofmotionofthekneewasalsomeasuredatthe5thdaypostoperatively.ResultsThe24一hourvolumeofthedrainageinthreeGroupswere(424.76士59.11)ml,(403.71士56.26)mland(404.15土51.89)ml,respectively.Therewerestatisticallysignificantdifferenc7、esamongthethreegroups;thenwecontinuetocarryoutthestatisticalanalysisbetweeneachother,wefoundoutthatthedifferencesbetweengroupAandgroupBwasstatisticallysignificantandthesameresultWasalsofoundbetweengroupAandgroupC.WhenitcalTletogroupBandgroupC
5、ents):theirhipwasplacedin4500felevation,andkneein70。offlexion;groupC(73patients):theirhipWasplacedin4500felevationwithkneeinextension.Alltheaboveinterventionslastedfor12hpostoperatively.Thewounddrainagewithnegativepressurewasremoved24hoursaftersurgeryinallgroups.The24hdrainagevolumeandthediff
6、erencebetweenpreoperativeandpostoperativehemoglobin(Hb)werecompared.Rangeofmotionofthekneewasalsomeasuredatthe5thdaypostoperatively.ResultsThe24一hourvolumeofthedrainageinthreeGroupswere(424.76士59.11)ml,(403.71士56.26)mland(404.15土51.89)ml,respectively.Therewerestatisticallysignificantdifferenc
7、esamongthethreegroups;thenwecontinuetocarryoutthestatisticalanalysisbetweeneachother,wefoundoutthatthedifferencesbetweengroupAandgroupBwasstatisticallysignificantandthesameresultWasalsofoundbetweengroupAandgroupC.WhenitcalTletogroupBandgroupC
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