| Background: The tourniquet plays an important role in controlling perioperative bleeding and other aspects of the Total knee arthroplasty(TKA).However,there is still a lack of sufficient scientific research to support the idea that the kind of tourniquet currently used to help patients with TKA obtain more satisfactory treatment results.Objective: To investigate the effect of different use of tourniquet on perioperative blood loss,inflammatory markers and thyroid function of TKA patients after immersion and washing with iodophor,and to analyze the effect of different use of tourniquet on knee joint activity and pain in the short term after operation.Methods: This study collected data of 70 knee joint disease patients who underwent unilateral total knee arthroplasty for the first time from January 2021 to December 2022,aged 52 to 83 years old.Among them,25 were males and 45 were females,with an average age of 69.67 ± 6.24 years.These patients did not receive blood transfusion during the perioperative period and they were randomly divided into two groups.35 patients were in the tourniquet group.These patients used tourniquet from the skin incision to the incision suture and pressure bandage binding;Thirty five patients were in the half way tourniquet group.tourniquet was used from the installation of prosthesis to the completion of incision suture and pressure bandage.After osteotomy and prosthesis installation treatment,100 ml of 5% iodophor was used to soak for five minutes,and then cleaned with 2500 ml of isotonic flushing solution.Detailed comparisons for surgical time,blood loss,inflammatory markers,thyroid function,ROM activity,and KSS scores,were made between the Two groups.Result: By comparing the surgeries of the two groups of patients,we found that their time was the same and there was no significant statistical difference(P>0.05).Patients who underwent full course treatment showed significantly lower explicit blood loss compared to the half course group,while implicit blood loss was significantly higher than the half course group.This difference was statistically significant(P<0.05),and the total blood loss between the two groups was not significantly different(P>0.05).There was no significant difference in preoperative inflammatory indicators between the two groups of patients(P>0.05).After surgery,the expression of inflammatory markers in the full course group was significantly higher than that in the half course group,and statistical analysis showed a significant difference(P<0.05).By studying the preoperative thyroid function of two groups of patients,we found that the differences between the two groups were not statistically significant(P>0.05).The patients who used tourniquet for half course operation had significantly lower three indexes of thyroid function(P<0.05).After preoperative ROM activity and KSS assessment,we found no significant statistical difference between the two groups of patients(P>0.05).However,postoperatively,we found that the ROM activity and KSS assessment of patients in the half course group showed higher levels(P<0.05).Conclusion: Through this study,we found that there is no significant difference in the total perioperative blood loss between half use of tourniquet and full use of tourniquet,but the recessive blood loss after surgery is reduced in half use of tourniquet as compared to full course of tourniquet.The postoperative inflammatory response is relatively lower in half-time group and the postoperative thyroid function is significantly affected.The patient’s pain decreased one day after surgery and their activity was good in the halfway tourniquet group.Neither group of patients experienced significant postoperative complications such as periprosthetic infection or thyroid dysfunction. |
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