摘要全膝关节置换术(total knee arthroplasty,TKA)是治疗终末期膝关节骨病的有效方法[1]。在年龄超过60岁的亚洲老年人口中,约15%的女性及6%的男性患有膝关节骨关节炎[2]。大多数骨科医生在TKA中采用止血带,止血带的使用会提供更好地手术视野、减少术中出血量及手术时间、改善骨骨水泥之间的交联[3]。但是由于止血带的使用及随后释放引发的机械性压迫和缺血再灌注(ischemia and reperfusion,I/R),会造成骨骼肌、神经、血管及脑、肺、肾等脏器的损伤[4],最终导致患者术后股四头肌萎缩、肌力下降,疼痛加剧,活动功能降低,康复及住院时间延长[5],也可增加患者术后总出血量以及深静脉血栓等并发症发生率[6]。这些由于止血带引起的副作用通常被称为止血带相关损伤[4]。近年来,国内外报道了很多关于TKA术后止血带相关损伤并提出了相应的改善方法,本文对此进行总结归纳,现综述如下。
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