Effect Of Tourniquet Usage Time On Blood Loss And Rehabilitation After Total Knee Arthroplasty

ObjectiveTo investigate the short-term use of tourniquet and tourniquet on the whole effect of total knee arthroplasty postoperative bleeding and early rehabilitation.method:Sixty patients who underwent the primary unilateral total knee arthroplasty from January 2018 to December 2018 in the China-Japanese Union Hospital of Jilin University were randomly divided into two groups:30 case in the experimental group(Install tourniquet before osteotomy and release tourniquet after cement fixation),and 30 case in the control group(Use tourniquet from the beginning of operation to the end of suture).Hematocrit,hemoglobin 24 hours before and after operation,intraoperative blood loss,range of motion and swelling of lower limbs were observed 3,5 and 7 days after operation,and pain was evaluated by VAS scoring system.Comparing the data difference between the two groups,when P<0.05,the difference was significant.Results:?The total blood loss was 644.48±434.66 ml in the experimental group and 502.56±280.68 ml in the control group,P>0.05.There was no significant difference between the two groups.Intraoperative blood loss was 239.07±45.75 ml in the experimental group and 80.16±19.10 ml in the control group,P<0.05.There was a statistical difference between the two groups.Intraoperative blood loss in the experimental group was significantly higher than that in the control group.Postoperative hemoglobin was 118.13±13.97g/L in the experimental group and 125.63±14.60/L in the control group,P>0.05.There was no significant difference between the two groups.Postoperative Hct in the experimental group was 0.37±0.05 and in the control group was 0.37±0.04,P>0.05.There was no significant difference between the two groups.Four patients in the experimental group received blood transfusion after operation,while three patients in the control group received blood transfusion.There was no significant difference between the two groups?The VAS score of the experimental group was 4.03±0.98 and 2.80±0.87 on the 3rd and 5th day after operation,and that of the control group was 4.70±1.16 and 3.33±1.01 on the 3rd and 5th day after operation.The P values were all less than 0.05.The difference was statistically significant.On the 7th day,the VAS score of the experimental group was 1.50±0.67,and that of the control group was 1.87±0.92,P>0.05.There was no significant difference between the two groups.The knee flexion angles of the experimental group were 71.53±5.19°,93.30±4.69° and 115.43±4.89° on the 3rd,5th and 7th day after operation,respectively,and those of the control group were 67.50±6.38°,90.03±5.730 and 112.03±5.73°,respectively.Comparing the data of the two groups,the p value is less than 0.05,so the difference has statistical significance.The increase of thigh swelling was 5.57±1.26 cm,2.84±1.13 cm and 1.39±0.96 cm in the experimental group and 6.65±1.68 cm,3.49±1.22 cm and 1.74±0.79 cm in the control group respectively on the 3rd,5th and 7th day after operation.The P value was less than 0.05.The difference was statistically significant.Conclusion? Short-term use of tourniquet has no significant effect on the total blood loss after operation,but compared with the whole use of tourniquet,the amount of intraoperative bleeding is increased.? Short-term use of tourniquet can reduce the degree of pain and swelling of knee joint after operation,which is conducive to the recovery of knee joint function after operation.