加速康复外科模式下全膝关节置换术围术期限制性输液的临床研究Perioperative restrictive fluid management in primary total knee arthroplasty with enhanced rehabilitation
张少云;黄强;曹国瑞;谢锦伟;雷一霆;裴福兴;
摘要(Abstract):
[目的]探讨加速康复外科模式下全膝关节置换术围术期限制性输液的安全性和有效性。[方法]回顾分析2015年7月~2016年1月行初次单侧全膝关节置换术手术当日自由性输液患者90例(对照组)和2016年2月~8月手术当日限制性输液患者70例(限制组)的临床资料。记录并比较两组患者围术期出入量情况、生命体征及不良事件发生情况。[结果]限制组手术当日平均输液量显著低于对照组[(1 532.76±296.51)ml vs(2 303.13±313.35)ml,P<0.001]。两组在手术时间、总失血量、术后每小时尿量、围术期血压及心率、术后住院时间方面差异无统计学意义(P>0.05)。限制组利尿剂及尿管使用率均低于对照组(11.40%vs 24.40%,P=0.036;15.70%vs 30.00%,P=0.035),但两组术后低血压、低钾血症、恶心呕吐、便秘发生率差异并无统计学意义(P>0.05)。[结论]加速康复外科模式下全膝关节置换术围术期采用限制性输液方案(手术当日输液量控制在1 500 ml左右)是安全有效的,但该结论仍需大样本前瞻性研究进一步证实。
关键词(KeyWords): 加速康复外科;全膝关节置换术;限制性输液;自由性输液
基金项目(Foundation): 卫生部2013年度卫生行业科研专项(项目编号:2013020007)
作者(Author): 张少云;黄强;曹国瑞;谢锦伟;雷一霆;裴福兴;
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DOI:
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