[1]丁皓原,周海波,韩大鹏,等.单髁置换术中止血带对膝骨关节炎患者围术期失血量的影响[J].中国中医骨伤科杂志,2025,33(08):30-36.[doi:10.20085/j.cnki.issn1005-0205.250806]
　DING Haoyuan,ZHOU Haibo,HAN Dapeng,et al.Effect of Tourniquet on Perioperative Blood Loss in Patients with Medial Compartment Knee Osteoarthritis Undergoing Unicompartmental Knee Arthroplasty[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(08):30-36.[doi:10.20085/j.cnki.issn1005-0205.250806]
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单髁置换术中止血带对膝骨关节炎患者围术期失血量的影响()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年08期
页码:
30-36
栏目:
临床研究
出版日期:
2025-08-15

文章信息/Info

Title:
Effect of Tourniquet on Perioperative Blood Loss in Patients with Medial Compartment Knee Osteoarthritis Undergoing Unicompartmental Knee Arthroplasty
文章编号:
1005-0205(2025)08-0030-07
作者:
丁皓原1; 周海波1; 韩大鹏2; 姚捷2; 高晨鑫2; 张璟2; 夏卿2; 欧阳桂林1; 2△
1上海中医药大学(上海,201203)
2上海中医药大学附属光华医院
Author(s):
DING Haoyuan1; ZHOU Haibo1; HAN Dapeng2; YAO Jie2; GAO Chenxin2; ZHANG Jing2; XIA Qing2; OUYANG Guilin1; 2△
1Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China; 2Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200052,China.
关键词:
膝骨关节炎;  单髁置换术;  止血带;  失血量;  高凝状态
Keywords:
knee osteoarthritis;  unicompartmental knee arthroplasty;  tourniquet;  blood loss;  hypercoagulable state
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.250806
文献标志码:
A
摘要:
目的:探讨止血带对内侧间室膝骨关节炎患者单髁置换围术期失血量的影响。方法:回顾性分析2022年1月至2024年10月行单侧单髁置换术的内侧间室骨关节炎患者207例,所有患者均在全麻下行内侧单髁置换术,非止血带组103例患者全程不使用止血带,止血带组104例患者全程使用止血带。记录并比较两组患者总失血量、术中出血量、显性失血量、隐性失血量、隐性失血百分比、手术时间、术后膝关节肿胀度、切口延迟愈合率、视觉模拟量表(VAS)评分和美国特种外科医院(HSS)评分。结果:非止血带组术中失血量高于止血带组,手术时间更长,术后1 d和7 d血红蛋白、红细胞压积高于止血带组,总失血量和隐性失血量低于止血带组,高凝状态发生率低于止血带组,术后VAS评分低于止血带组,HSS评分高于止血带组,差异有统计学意义(P<0.05)。两组患者术后均未出现切口愈合不良的情况。结论:内侧间室骨关节炎患者行单髁膝关节置换术全程不使用止血带可以减少围术期失血量及术肢肿胀的发生,降低术后高凝状态的发生率,且不会影响术后早期的膝关节功能恢复及切口愈合。
Abstract:
Objective:To investigate the effect of tourniquet on perioperative blood loss in patients with medial compartment knee osteoarthritis undergoing unicompartmental knee arthroplasty.Methods:A retrospective analysis of 207 patients with medial compartment osteoarthritis who underwent unilateral unicompartmental knee arthroplasty from January 2022 to October 2024.All patients underwent medial unicompartmental knee arthroplasty under general anesthesia.103 patients in the non-tourniquet group did not use tourniquets throughout the course,and 104 patients in the tourniquet group used tourniquets throughout the course.The total blood loss,intraoperative blood loss,dominant blood loss,hidden blood loss,hidden blood loss percentage,operation time,postoperative knee swelling,incision delayed healing rate,visual analogue scale(VAS)score and Hospital for Special Surgery(HSS)score were recorded and compared between the two groups.Results:The intraoperative blood loss in the non-tourniquet group was higher than that in the tourniquet group,and the operation time was longer.The hemoglobin and hematocrit at 1 d and 7 d after operation were higher than those in the tourniquet group.The total blood loss and hidden blood loss were lower than those in the tourniquet group.The incidence of hypercoagulability was lower than that in the tourniquet group.The postoperative VAS score was lower than that in the tourniquet group,and the HSS score was higher than that in the tourniquet group.The difference was statistically significant(P<0.05 ).There was no poor wound healing in the two groups after operation.Conclusion:For patients with medial compartment osteoarthritis undergoing unicompartmental knee arthroplasty,no tourniquet use during the whole process can reduce perioperative blood loss and limb swelling,reduce the incidence of postoperative hypercoagulability,and will not affect the early postoperative knee function recovery and incision healing.

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备注/Memo

备注/Memo:
基金项目:上海市卫生健康委员会科研项目(2021Y0168)
上海市长宁区科学技术委员会科研课题(CNKW2022Y22)
上海市长宁区卫生健康委员会科研项目(20214Y021)
△通信作者 E-mail:oyglmd@hotmail.com
更新日期/Last Update: 2025-08-15