Objective To investigate the time choice of early clipping drainage tube after total knee arthro -platy.Method 120 patients with unilateral total knee arthroplasty were randomly divided into four groups(non-clipping group,clipping 1 h,2 h,4 h).The preoperative and postoperative Hb,HCT,the total blood loss,the total drainage vol-ume and the blood transfusion volume after postoperative 48 hours,the HSS score of knee-joint motion range after surgery were recorded for further analysisincluding the assessment postoperative limb swelling and subcutaneous ecchymosis.Re-sult No statistically significant difference were observed in the preoperative Hb and HCT among the four gourps(P>0.05).Postoperative Hb and HCT were less than preoperative in each group,the differences were statistically significant (P<0.05).Volume of drainage of not clipping group was more than the other groups in the comparison of the total blood loss,including index of preoperative and postoperative Hb,the blood transfusion volume,blood transfusion rate. Similar differences were observed among clipping 2 h,4 h groups and clipping 1 h group,the differences was statistically significant(P<0.05),however,there was no statistically significant differemce between clipping 2 h group and clipping 4 h group.In the comparison of the volume of drainage after postoperative 48 h,not clipping group had the most volume while clipping 4 h group had the least,the difference was statistically significant(P<0.05).The occurrence of joint swelling and subcutaneous ecchymosis in clipping 4h group was higher than the other groups,and the differences were statistically significant(P<0.05).HSS score of four groups had no statistically significant differences(P>0.05).In the term of the knee-joint motion range,non-clipping group was biggest and clipping 4h group was smallest,the differ-ence was statistically significant(P<0.05).Conclusion Clipping drainage tube 2 h after total knee arthroplasty is the ideal time to choose.%目的 探讨人工全膝关节术后夹闭引流管最适时长的选择.方法 选取拟行单侧全膝关节置换术的膝骨关节炎患者120例,按照入院顺序编号,随机分组,分为4组(A组:持续引流组;B组:夹闭1 h组;C组:夹闭2 h组;D组:夹闭4 h组),每组30例.观察各组术前及术后48 h血红蛋白浓度(Hb)和红细胞比容(HCT)、总失血量、术后48h引流量、输血量、术后美国膝关节协会评分(KSS评分)、膝关节活动度,关节肿胀、皮下瘀斑情况.结果 四组术前Hb、HCT差异均无统计学意义(P>0.05);各组内术后Hb、HCT均小于术前,差异有统计学意义(P<0.05);各组间总失血量、术前Hb与术后Hb差值、全组平均输血量、输血率的比较中持续引流组大于其余各组,夹闭1h组大于2h、4h组,均差异有统计学意义(P<0.05),而夹闭2h与4h组之间,差异无统计学意义(P>0.05);术后48 h引流量的比较中各组间差异均有统计学意义(P<0.05),且持续引流组最大,夹闭4 h组最小;四组术后情况比较中,夹闭4 h组关节肿胀和皮下瘀斑发生率明显增高;HSS评分方面,四组差异无统计学意义(P>0.05);关节活动度方面持续引流组大于其余各组(P<0.05),夹闭1 h与2 h组差异无统计学意义(P>0.05),夹闭4 h小于其余各组(P<0.05).结论 全膝关节置换术后夹闭引流管2 h是最理想的时间选择.
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