|
|
Meta-analysis of tourniquet in total knee arthroplasty |
ZENG Li1 YAN Bing1 WANG Yongcai1 WANG Hongchuan1 XING Gengyan2 |
1.Department of Orthopedics, the People′s Hospital of Leshan, Sichuan Province, Leshan 614000, China;
2.Orthopaedic Center, the Third Medical Center of Chinese People′s Liberation Army General Hospital, Beijing 100039, China
|
|
|
Abstract Objective To study the effect of balloon tourniquet in total knee arthroplasty (TKA) on operation time, total blood loss and knee range of motion 7 days after operation. Methods Chinese Biomedical Literature Database, Viper Database, CNKI, WanFang Data Knowledge Service Platform, PubMed, Cochrane Library and EMbase were searched by computer. The retrieval time was from database construction to December 2018. All the randomized controlled trials conducted during the operation were collected that the experimental group using tourniquets as the tourniquet group and none using tourniquets as the control group. Differences in operation time, total blood loss and knee range of motion 7 days after operation were compared between the two groups, and meta analysis was performed using RevMan5.3.0 software. Results A total of 14 randomized controlled studies including 924 patients were included in the study. The results of meta-analysis showed that the operation time of the tourniquet group was shorter than that of the control group, and the difference was statistically significant [WMD = -3.66, 95%CI (-5.94, -1.37), P = 0.002]. There was no statistically significant difference between the two groups in total blood loss and knee range of motion 7 days after operation (P > 0.05). Conclusion The use of tourniquet during TKA can reduce the operation time, but it has no effect on the total blood loss and knee range of motion 7 days after operation.
|
|
|
|
|
[1] Cross M,Smith E,Hoy D,et al. The global burden of hip and knee osteoarthritis:estimates from the global burden of disease 2010 study [J]. Ann Rheum Dis,2014,73(7):1323-1330.
[2] Abdel-Salam A,Eyres KS. Effects of tourniquet during total knee arthroplasty. A prospective randomised study [J]. J Bone Joint Surg Br,1995,77(2):250-253.
[3] 顾培伦,董金波,王维山,等.人工全膝关节置换中是否应用气囊止血带止血:一项Meta分析[J].中国组织工程研究,2018,22(15):2446-2452.
[4] Aglietti P,Baldini A,Vena LM,et al. Effect of Tourniquet Use on Activation of Coagulation in Total Knee Replacement [J]. Clin Orthop Relat Res,2000,371:169-177.
[5] Fukuda A,Hasegawa M,Kato K,et al. Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty [J]. Arch Orthop Trauma Surg,2007,127(8):671-675.
[6] Nobuya K,Kazuhiro N,Shinichi Y,et al. Abnormal Echogenic Findings Detected by Transesophageal Echocardiography and Cardiorespiratory Impairment during Total Knee Arthroplasty with Tourniquet [J]. Anesthesiology,2002,97:1123-1128.
[7] Matziolis G,Drahn T,Schr?觟der JH,et al. Endothelin-1 is secreted after total knee arthroplasty regardless of the use of a tourniquet [J]. J Orthop Res,2005,23(2):392-396.
[8] Tetro AM,Rudan JF. The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty [J]. Can J Surg,2001,44(1):33-38.
[9] Vandenbussche E,Duranthon LD,Couturier M,et al. The effect of tourniquet use in total knee arthroplasty [J]. Int Orthop,2002,26(5):306-309.
[10] Wauke K,Nagashima M,Kato N,et al. Comparative study between thromboembolism and total knee arthroplasty with or without tourniquet in rheumatoid arthritis patients [J]. Arch Orthop Traum Surg,2002,122(8):442-446.
[11] 周俊,钭伟国,欧阳海清,等.全膝关节置换术中不应用止血带对患者术后的影响[J].中国乡村医药,2018,25(23):10-11,13.
[12] 张琦,董纪元,龚科,等.应用止血带对人工全膝关节置换术的影响研究[J].中国修复重建外科杂志,2016,30(4):421-425.
[13] 徐德利,林浩,陶海鹰.前瞻性随机对照研究总结评估止血带在初次全膝关节表面置换术中的应用价值研究[J].河北医学,2017,23(8):1330-1335.
[14] 谢小伟,岳辰,黄泽宇,等.全膝关节置换术应用与不应用止血带的随机对照研究[J].中国矫形外科杂志,2017, 25(17):1572-1576.
[15] 邓立庆,冯品,甘彦峰,等.不使用止血带在全膝关节置换术中的临床效果评价[J].中国矫形外科杂志,2017, 25(23):2186-2189.
[16] Wakankar HM,Nicholl JE,Koka R,et al. The tourniquet in total knee arthroplasty. A prospective randomised study [J]. J Bone Joint Surg Br,1999,81(1):30-33.
[17] 王永才,王红川,蒋俊威.止血带的不同使用方法在膝关节置换术中的研究[J].中华关节外科杂志:电子版,2013,7(3):346-349.
[18] 毕艳玲,黄浩.患者自主疼痛评估在全膝关节置换术围术期疼痛管理中的应用价值分析[J].中国医药科学,2019,9(23):267-269.
[19] 李娜.全膝关节置换术后康复护理对患者关节肿胀、疼痛的影响[J].中国现代医生,2019,57(25):155-157.
[20] 黄鹏,张昊华,刘艳成,等.膝关节置换后康复远程监测系统的应用研究[J].北京生物医学工程,2018,37(1):66-72,102.
[21] Touzopoulos P,Ververidis A,Mpogiatzis C,et al. The use of tourniquet may influence the cement mantle thickness under the tibial implant during total knee arthroplasty [J]. Eur J Orthop Surg Traumatol,2019,29(4):869-875.
[22] 孙赫,吴栩,曹学伟.TKA术后患肢屈曲位对隐性出血和活动度影响的Meta分析[J].中国矫形外科杂志,2017, 25(7):621-627.
[23] 刘燕媚.中医综合护理干预对人工全膝关节置换患者术后肿胀发生率及关节活动度的影响[J].中国医药科学,2019,9(9):98-100,200.
[24] 李新天,王炜,林进,等.以无痛锻炼为核心的快速康复方案对全膝关节置换术后康复效果的影响[J].中国医药,2018,13(4):573-577.
[25] 张伪松,郝定均.人工全膝关节置换术中屈曲间隙大于伸直间隙的研究进展[J].中国修复重建外科杂志,2017, 31(5):620-623. |
|
|
|