全膝置换术是否留置引流管对康复的影响△（开放获取）

(Open Access) Impact of indwelling drainage on rehabilitation in total knee arthroplasty

摘要:

[目的] 比较全膝置换术（total knee arthroplasty, TKA） 后是否留置引流管对膝骨关节炎患者膝功能康复的影响。[方法] 回顾性分析2019 年7 月—2023 年1 月于本院接受TKA 的130 例膝骨关节炎患者的临床资料。根据医患沟通结果，65 例患者未放置引流管，另外65 例放置引流管。比较两组患者围手术期和随访结果。[结果] 全部患者均顺利完成手术，无引流组在总失血量[(340.8±101.5) ml vs (389.2±80.8) ml, P=0.049]、术后住院时间[(2.0±0.7) d vs (4.4±0.9) d, P＜0.001] 显著少于引流组。两组术后并发症发生率的差异无统计学意义（P＞0.05）。随时间推移，两组患者疼痛VAS 评分均显著减少（P＜0.05），膝伸屈ROM、AKSS 功能评分均显著增加（P＜0.05）。术后1 个月，无引流组的VAS 评分[(1.7±0.7) vs (2.7±1.0), P=0.002]、膝伸屈ROM[(119.8±4.1)° vs (116.3±6.6)°, P＜0.001] 显著优于引流组。[结论] 相比留置引流管，全膝置换术后无引流管具有减轻患者术后近期疼痛，缩短住院时间的优势。

Abstract:

[Objective] To compare the clinical consequences of total knee arthroplasty (TKA) for knee osteoarthritis (KO) with or with-out indwelling drainage tube. [Methods] A retrospective study was conducted on 130 patients who received TKA for KO in our hospital fromJuly 2019 to January 2023. According to the results of doctor-patient communication, 65 patients had not drainage placed (the ND group) ,whereas other 65 patients had drainage placed (the D group). The documents regarding to perioperative period and follow-up were comparedbetween the two groups. [Results] All patients in both groups had TKA performed successfully. The ND group proved significantly superiorto the D group in terms of total blood loss [(340.8±101.5) ml vs (389.2±80.8) ml, P=0.049] and postoperative hospital stay [(2.0±0.7) days vs(4.4±0.9) days, P＜0.001], although there was no significant difference in the incidence of postoperative complications between the twogroups (P＞0.05). As time went on, the pain VAS scores significantly decreased (P＜0.05), while the knee flexion-extension range of motion(ROM) and AKSS scores significantly increased in both groups (P＜0.05). The ND group proved significantly better than the D group in termsVAS score [(1.7±0.7) vs (2.7±1.0), P=0.002], the knee ROM [DHS (119.8±4.1)° vs (116.3±6.6)°, P＜0.001] 1 month postoperatively. [Conclu-sion] Compared with indwelling drainage, no indwelling drainage after total knee arthroplasty has the advantages of reducing short-term post-operative pain and shortening hospital stay.