Comprehensive Measures To Reduce Total Knee Resurfacing Arthroplasty Postoperative Drainage

Objective:Explore through retrospective analysis and comparison ofcomprehensive measures to reduce total knee resurfacing arthroplasty postoperativedrainage.Methods:Sixty-seven elderly patients which had TKA operation from march2010to march2013inour hospital are included in the study. There are male13casesand female54cases, which are ranged from56to81years old, and their average ageare68.5years old. They are divided into two groups: proved group and traditional group.The proved group have35people (50knees)(unilateral TKA20people, bilateral TKA15people),and the traditional group have32people(45knees)(unilateral TKA19people,bilateral TKA13people). Reference to the Gross study, blood loss volume is calculatedaccording to the changes of the red blood cell volume before and afteroperation:preoperative blood volume(PBV)=k1×heighe(m)3+k2×weight （kg）+k3;Total blood loss=PBV×(preoperative Hct-postoperative Hct)+red blood cellinput. We observe the total drainage after operation for24h, the preoperative andpostoperative day second of hemoglobin and hematocrit, the hidden hemorrhage,thetotal blood loss,the joint swelling,the superficial blisters,the intraoperative andpostoperative blood transfusion,with or without ecchymosis,deep vein thrombosis, andscore HSS various effects before and after treatment.In the experiment, we use theSPSS17.0statistical package for the Social Sciences, measurement data using the mean±standard deviation (x±S), t test or rank sum test used in the middle of the both group,percentage byX2test,differences in the level is set to0.05.Results:Through the contrast test, we get a conclusion: the averagedrainagevolume in theimproved groupin the24h is310.4±196.21ml,the traditional group is573.39±259.45ml. From here we see that the improved group is significantlyless thanthetraditional group,comparison is statistically significant(p<0.05). The averagevolume of blood transfusion of the improved groupis203.7±142.51ml, the traditionalgroup is413.61±302.22ml, the improved group is obviouslyless thanthetraditionalgroup,the difference is statistical (p <0.05);and in theimproved groupthe bloodtransfusionratethat is35.64%islower than the traditionalgroup(66.34%), there isstatistical difference(p <0.05).Theaveragetotal blood lossis534.67±248.5ml in theimproved group,the traditional groupis810.76±313.66ml, and we can obviously see thatthe improvedgroup is significantlyless thanthetraditional group,there is statisticallysignificant(p<0.05).The hidden hemorrhageof the improved group is240.83±161.78ml,the traditional groupis213.23±130.12ml, and then there isnostatistical significance (p>0.05).Contrasting the preoperative hemoglobin, hematocritand postoperative hemoglobin, hematocrit, we found that there is no difference (P>0.05).In the patients of two group, the deep vein thrombosis, joint swelling,superficial blisters,limb petechiae is found. But from the complicationrate of statistics of the two groups,there is no statistical difference (P>0.05). The averagescore of Knee HSS is91.26±8.31points in the improved group, compared to the traditional group for the average of91.13±6.43points, there is no statistical significance (P>0.05). The excellent rate ofscore of knee HSS is98.56%in the improved group, for traditional group99.12%, andthe contrast is no statistical significance (P>0.05).Conclusion:In this paper,the comparative analysis found that the comprehensivemeasures in reducing total knee arthroplasty postoperative drainage is significantly,which is better than traditional single method.The data show that the improved groupcan significantly reduce thepostoperative total knee resurfacing arthroplasty afterdrainage24h,the total amount of blood loss, the amount of postoperative bloodtransfusion and transfusion rate,compared to the traditional group,there is statisticallysignificant,and can reducethe potential dangers of the various transmitted diseases dueto postoperative transfusion. Andthe improved group do not increase the incidence therate of postoperative deep vein thrombosis,limb petechiae,superficial blisters and othercomplications, so this is an effective measure which is clinically used to reduce totalknee resurfacing arthroplasty postoperative drainage.