TKA术后夹闭和开放引流管对出血量和输血量影响的比较研究

前瞻性研究全膝关节置换术（TKA）术后引流管夹闭4小时对患者术后出血量和输血量的影响。将我院2010年2月至2011年2月因骨性关节炎晚期行TKA的患者71例，随机分为两组。一组为夹闭引流管组，另一组为持续开放引流管组。两组均于术后48小时拔出引流管。将两组患者术前及术后1天、2天、3天的血红蛋白（HB）计数、术后引流液量及术后输血量进行比较。结果显示，夹闭引流管组与持续开放组患者相比，两组切口引流量存在差异。因此，与持续开放引流管方法相比，TKA术后采用夹闭引流管4小时的方法可以减少引流量，但不减少术后出血量及输血量。

Analysis of Role Morality on Community Nurses

This prospective study aimed to discuss the effects of the amount of postoperative drainage and blood transfusion in total knee arthroplasty （TKA） with drainage tube clamped for 4 hours. The 71 osteoarthritis patients in our hospital from February of 2010 to February of 2011 which had the surgery of TKA （total knee arthroplasty） were randomly divided into two groups. One group included 32 cases （44 knees） with drainage tube clamped for 4 hours and negative pressure drainage. Another group included 39 cases （51 knees） continuous open drainage after surgery. Drainage of two groups were extracted in 48 hours after the surgery. The groups were compared for their preoperative and postoperative 3-day haemoglobin （HB） levels, total drainage amount and postoperative blood transfusions. The drainage of the two groups was dif ferent with statistical significance （P〈0.05）. The mean number of transfusions was 1.41 units with no significant differences between the groups. Compared with continuous open drainage, the methord of drainage tube clamped for 4 hours can reduce the drainage volume, but it can not decrease the volume of bleeding and the rate of blood postoperative blood transfusion.