The First Half and Full Use of a Tourniquet Comparison of Early Rehabilitation and Blood Loss after Knee Replacement
Abstract: Research Purpose: To compare the releasing tourniquet after prothesis placement using tourniquet during the whole-course in the case of hemorrhage resulting from total knee joint replacement and early rehabilitation. Method: Adopting prospective randomized controlled method, the research has taken the cases in the Surgical Department of Affiliated Hospital of Qingdao University from March 1, 2015 to July 1, 2016 as examples. Patients were diagnosed with left (right) knee osteoarthritis and the first time to receive total knee replacement (TKA). During operation 50 pa-tients were divided into two groups at random: the first half cases used 50 tourniquets (first half group), and patients using tourniquets during the whole course were 50 cases (whole course group). Duration of operation, bleeding volume in surgery, perioperative transfusion volume, deep vein thrombosis of the lower extremity, pulmonary embolism number, perimeter of 10 cm above knee 3 days after operation, VAS score of 7 days after operation, HSS score, number of tension vesicle cases, CPM functional exercise degree 3 days after operation, admission HCT, drainage volume on the 1st day after operation, and HCT 3 days after operation were recorded and compared between groups. Outcome: Compared with the whole course group, the first half group had longer duration of operation; HCT value was higher on the 1st and 3rd day of the operation; bleeding volume and amount of erythrocyte loss were larger during operation; total erythrocyte and hidden erythrocyte loss were less; drainage volume was less after the 1st and 2nd days of operation; patient’s HSS score was higher after a week of operation; perimeter of 10 cm above knee was smaller 3 days after operation; VAS score was lower 7 days after operation; CPM functional exercise degree reached higher 3 days after operation; number of tension vesicle cases was smaller; the differences were of statistical significance. Conclusion: Compared with the whole course group, using tourniquets in the first half group not only has reduced hidden erythrocyte loss and total erythrocyte loss, but also was beneficial to patients’ early recovery, dropping incidence rate of phlebothrombosis, pulmonary embolism and other complications. Therefore it is worth adopting.
文章引用: 周 峰 , 夏长所 , 李娅娟 , 韩建玲 , 张才龙 (2016) 前半程与全程使用止血带在膝关节置换术后失血与早期康复的对比。 亚洲外科手术病例研究， 5， 10-16. doi: 10.12677/ACRS.2016.52003
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