膝关节单髁置换术中止血带的使用策略研究

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Abstract

Objective To investigate the effects of different tourniquet strategies on the perioperative blood loss，postoperative function and complications of unicompartmental knee arthroplasty.Methods 97 patients who underwent primary UKA in our hospital from January 2018 to December 2018 were retrospectively reviewed and divided into the whole process group (12 males and 21 females)，the optimized group (11 males and 19 females) and no tourniquet group (13 males and 21 females)，according to the way of tourniquet use.We recorded the operation time，intraoperative blood loss，postoperative drainage，recessive blood loss，VAS score and swelling rate on the first postoperative day，range of motion at discharge，hospital stays and number of complications and collected knee HSS score at follow-up.Results The operation time of the whole process group and the optimized group was shorter，and the amount of intraoperative blood loss was less (P＜0.05).However，the postoperative drainage，hemoglobin reduction，recessive blood loss，VAS score swelling rate，range of motion，the number of minor complications，the hospital stay and the HSS score at one month were significantly betterin the optimized group and the no tourniquet group than in the whole process group (P＜0.05).There was no statistically significant difference in the number of severe complications and the HSS score at follow-up between the three groups (P＞0.05).Conclusion During Unicompartmental Knee Arthroplasty，optimization of tourniquet usage can effectively reduce intraoperative blood loss and reduce the operation time，without affecting the early recovery of the patient and increase the incidence of complications.

Key words： unicompartmental knee arthroplasty tourniquet recessive blood loss complications

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［1］Bannuru RR，Osani MC，Vaysbrot EE，et al.OARSI guidelines for the non-surgical management of knee，hip，and polyarticular osteoarthritis［J］.Osteoarthritis Cartilage，2019，27(11)：1578-1589.
［2］Zuiderbaan HA，Van Der List JP，Khamaisy S，et al.Unicompartmental knee arthroplasty versus total knee arthroplasty：Which type of artificial joint do patients forget［J］.Knee Surg Sports TraumatolArthrosc，2017，25(3)：681-686.
［3］Wilson HA，Middleton R，Abram SGF，et al.Patient relevant outcomes of unicompartmental versus total knee replacement：systematic review and meta-analysis［J］.BMJ，2019(364)：1352.
［4］Arthur JR，Spangehl MJ.Tourniquet use in total knee arthroplasty［J］.J Knee Surg，2019，32(8)：719-729.
［5］Tarwala R，Dorr LD，Gilbert PK，et al.Tourniquet use during cementation only during total knee arthroplasty：a randomized trial［J］.Clin Orthop Relat Res，2014，472(1)：169-174.
［6］Olivecrona C，Ponzer S，Hamberg P，et al.Lower tourniquet cuff pressure reduces postoperative wound complications after total knee arthropIasty：a randomized controlled study of 164 patients［J］.J Bone Joint Surg (Am)，2019，94(24)：2216-2221.
［7］Berry DJ，Bozic KJ.Current practice patterns in primary hip and knee arthroplasty among members of the American association of hip and knee surgeons［J］.J Arthroplasty，2010，25(6)：2-4.
［8］虞宵，章鸿，繆烨，等.骨水泥型全膝关节置换术中止血带应用策略的研究［J］.生物骨科材料与临床研究，2018，15(3)：42-44；49.
［9］中国研究型医院学会关节外科学专业委员会膝关节部分置换研究学组.膝关节单髁置换术围手术期管理专家共识［J］.中华骨与关节外科杂志，2020，13(4)：265-271.
［10］周晓强，虞宵，荆翔，等.静脉应用氨甲环酸联合局部灌注含氨甲环酸混合镇痛药物在单髁置换术中的应用［J］.中国骨与关节损伤杂志，2020，35(4)：401-404.
［11］朱东平，杨伟毅，卢明峰，等.全程出血管理条件下单髁置换术后出血及凝血规律的研究［J］.实用骨科杂志，2018，24(4)：306-309.
［12］Nadler SB，Hidalgo JH，Bloch T.Prediction of blood volume in normal human adults［J］.Surgery，1962，51(2)：224-232.
［13］Gross JB.Estimating allowable blood loss：corrected for dilution［J］.Anesthesiology，1983，58(3)：277-280.
［14］AlcelikI，Pollock RD，Sukeik M，etal.A comparison of outcomes with and without a tourniquet in total knee arthroplasty：a systematic review and meta analysis of randomized controlled trials［J］.J Arthroplasty，2012，27 (3)：331-340.
［15］Wang K，Ni S，Li Z，et al.The effects of tourniquet use in total knee arthroplasty：a randomized，controlled trial［J］.Knee Surg Sports Traumatol Arthrosc，2017，25(9)：2849-2857.
［16］Schnettler T，Papillon N，Rees H.Use of a tourniquet in total knee arthroplasty causes a paradoxical increase in total blood loss［J］.J Bone Joint Surg (Am)，2017，99(16)：1331-1336.
［17］Zhou K，Ling T，Wang H，et al.Influence of tourniquet use in primary total knee arthroplasty with drainage：a prospective randomised controlled trial［J］.J Orthop Surg Res，2017，12(1)：172.
［18］Huang Z，Xie X，Li L，et al.Intravenous and topical tranexamic acid alone are superior to tourniquet use for primary total knee arthroplasty：a prospective，randomized controlled trial［J］.J Bone Joint Surg (Am)，2017，99(24)：2053-2061.
［19］Alexandersson M，Wang EY，Eriksson S.A small difference in recovery between total knee arthroplasty with and without tourniquet use the first 3 months after surgery：a randomized controlled study［J］.Knee Surg Sports Traumatol Arthrosc，2019，27(4)：1035-1042.
［20］Ejaz A，Laursen AC，Kappel A，et al.Tourniquet induced ischemia and changes in metabolism during TKA：a randomized study using microdialysis［J］.BMC Musculoskelet Disord，2015(16)：326.
［21］Goel R，Rondon AJ，Sydnor K，et al.Tourniquet use does not affect functional outcomes or pain after total knee arthroplasty：A prospective，doubleblinded，randomized controlled trial［J］.J Bone Joint Surg (Am)，2019，101(20)：1821-1828.
［22］Wang C，Zhou C，Qu H，et al.Comparison of tourniquet application only during cementation and long-duration tourniquet application in total knee arthroplasty：a meta-analysis［J］.J Orthop Surg Res，2018，13(1)：216.
［23］Li X，Yin L，Chen ZY，et al.The effect of tourniquet use in total knee arthroplasty：grading the evidence through an updated meta analysis of randomized，controlled trials［J］.Eur J Orthop Surg Traumatol，2014，24(6)：973-986.