低能量胫骨平台骨折术中止血带不同应用方式的效果比较
|
摘要
目的:分析低能量胫骨平台骨折术中止血带不同应用方式对临床疗效的影响。方法:选取本院需要手术治疗的SchatzerⅠ-Ⅲ型低能量胫骨平台骨折患者,按随机数字法分组,单数为止血带组,全程使用止血带,双数为非止血带组,术中不使用止血带,观察两组患者手术时间、术中出血量、总出血量(显性+隐性)、患肢肿胀情况(周径增加率)、疼痛VAS评分、HSS评分。结果:非止血带组患肢肿胀情况、疼痛评分均低于止血带组,HSS评分高于止血带组,而手术时间增加有限,总出血量两组相当。结论:低能量胫骨平台骨折术中不使用止血带,能促进患者快速康复,减轻疼痛,值得临床推广。
Objective: To analyze the effect of different application methods of tourniquet on the clinical efficacy of low-energy tibial plateau fractures. Methods: The patients with Schatzer type I-III low-energy tibial plateau fracture who needed operation were divided into two groups according to random number method. The single group was used in the whole process of tourniquet,and the double group was not used in the operation. The operation time,intraoperative bleeding volume and total bleeding volume( dominant + recessive bleeding),limb swelling( circumference increment rate),pain VAS score and HSS score of the two groups were observed. Results: The swelling and pain scores of the affected limbs in the non-tourniquet group were lower than those in the tourniquet group.The HSS scores in the non-tourniquet group were higher than those in the tourniquet group. The operation time was limited,and the total bleeding volume( dominant + recessive bleeding) was the same in the two groups. Conclusion: The non use of tourniquet during the operation of low energy tibial plateau fractures can promote the rapid recovery of patients and relieve pain,which is worthy of clinical promotion.
Objective: To analyze the effect of different application methods of tourniquet on the clinical efficacy of low-energy tibial plateau fractures. Methods: The patients with Schatzer type I-III low-energy tibial plateau fracture who needed operation were divided into two groups according to random number method. The single group was used in the whole process of tourniquet,and the double group was not used in the operation. The operation time,intraoperative bleeding volume and total bleeding volume( dominant + recessive bleeding),limb swelling( circumference increment rate),pain VAS score and HSS score of the two groups were observed. Results: The swelling and pain scores of the affected limbs in the non-tourniquet group were lower than those in the tourniquet group.The HSS scores in the non-tourniquet group were higher than those in the tourniquet group. The operation time was limited,and the total bleeding volume( dominant + recessive bleeding) was the same in the two groups. Conclusion: The non use of tourniquet during the operation of low energy tibial plateau fractures can promote the rapid recovery of patients and relieve pain,which is worthy of clinical promotion.
引文
[1]Momaya AM,Hlavacek J,Etier B,et al. Risk factors for infection after operative fixation of tibal plateau fracture[J]. Injury,2016,47(7):1501-1 505.
[2]潘凡武,毕树雄.气压止血带在四肢骨科手术中的应用研究进展[J].国际骨科杂志,2011,32(1):33-36.
[3]周宗科,翁习生,曲铁兵,等.中国髋、膝关节置换术加速康复--围手术期管理策略专家共识[J].中华骨与关节外科杂志,2016,9(2):1-9.
[4]华莹奇,张治宇,蔡郑东.快速康复外科理念在骨科的应用现状与展望[J].中华外科杂志,2009,7(10):1 505-1 507.
[5]Nadler SB,Hidalgo JH,Bloch T. Prediction of blood volum in normal human adults[J]. Surgery,1962,51(2):224-232.
[6]Mercuriali F,Inghilleri G. Proposal of an algorithm to help the choice of the best transfusion strategy[J]. Curr Med Res Opin,1996,13(8):465-478.
[7]张岩,王震,肖银龙,等.胫骨平台骨折内固定术后引流量增多的危险因素分析[J].实用骨科杂志,2017,23(8):703-705.
[8]冯卫东,芦浩,王文革.双膝关节一期置换术中静脉及局部应用氨甲环酸的对照研究[J].实用骨科杂志,2017,23(12):1 141-1 143.
[2]潘凡武,毕树雄.气压止血带在四肢骨科手术中的应用研究进展[J].国际骨科杂志,2011,32(1):33-36.
[3]周宗科,翁习生,曲铁兵,等.中国髋、膝关节置换术加速康复--围手术期管理策略专家共识[J].中华骨与关节外科杂志,2016,9(2):1-9.
[4]华莹奇,张治宇,蔡郑东.快速康复外科理念在骨科的应用现状与展望[J].中华外科杂志,2009,7(10):1 505-1 507.
[5]Nadler SB,Hidalgo JH,Bloch T. Prediction of blood volum in normal human adults[J]. Surgery,1962,51(2):224-232.
[6]Mercuriali F,Inghilleri G. Proposal of an algorithm to help the choice of the best transfusion strategy[J]. Curr Med Res Opin,1996,13(8):465-478.
[7]张岩,王震,肖银龙,等.胫骨平台骨折内固定术后引流量增多的危险因素分析[J].实用骨科杂志,2017,23(8):703-705.
[8]冯卫东,芦浩,王文革.双膝关节一期置换术中静脉及局部应用氨甲环酸的对照研究[J].实用骨科杂志,2017,23(12):1 141-1 143.