目的 观察全膝关节置换术后早期暂时夹闭伤口引流管及夹管时间对引流量的影响.方法 2008年1月-2010年6月行全膝关节置换术患者64例,根据入院时间先后随机分为观察组一22例、观察组二22例、对照组20例.观察组一于手术完成后即刻夹闭引流管2 h,2 h后开放计量;观察组二于手术完成后即刻夹闭引流管4 h,4 h后开放计量;对照组于术后按传统方法始终保持引流通畅;均于术后24～48 h拔管.记录各组术后48 h内伤口引流量,切口愈合情况及出院时膝关节功能评分.结果 术后48 h内伤口引流量各组差异有统计学意义(P<0.05),观察组二伤口引流量最低;术后切口愈合时间及出院时膝关节功能评分各组间比较差异均无统计学意义(P>0.05);均未出现切口感染、裂开、脂肪液化等情况.结论 全膝关节置换术后早期暂时夹闭伤口引流管能减少伤口引流量,夹闭4 h效果优于2 h,且对切口愈合、膝关节术后功能恢复无不良影响.%Objective To observe the effect of temporarily-closed wound drainage tube and time of clipping pipe on drainage volume early after knee replacement surgery. Methods 64 patients with total knee replacement surgery were randomly divided into observation group 1, observation group 2 and control group. The drainage tube in observation group 1 was closed 2 hours after the surgery and 4 hours after the surgery in observation group 2, while the drainage tube was kept open in control group. The volume of wound drainage 48 h after the surgery was recorded and analyzed. Results Average volume of wound drainage in observation groups 48 hour after surgery was significantly less than that of control group. Average volume of wound drainage in observation group 2 was noticeably less than that in observation group 1. No significant differences existed in scores of knee joint function among three groups. Conclusion During total knee arthroplasty, closing drainage tube early after the surgery can decrease the volume of bleeding. The effect of keeping tube close for 4 hours is better than that for 2 hours and no adverse effects on healing of incision and knee functional recovery exist.
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