| Objective:At present,there is still controversy about whether to indwell a drainage tube after total hip replacement.Comparing the effects of indwelling drainage on total perioperative blood loss,initial postoperative functional status and incision complications.To evaluate the safety of irregular indwelling drainage through the incision after Total hip arthroplastyMethods:A retrospective analysis of the data of patients who Visited the Orthopedics Department of Affiliated Zhongshan Hospital of Dalian University to underwent biotype total hip arthroplasty by Hardinge Surgical approach from September 2018 to December 2020.According to whether the drainage tube was indwelled during the operation,they were divided into drainage group and non-drainage group.There were 73 cases in the drainage group,including 30 males and 43 females;the non-draining group had 120 cases,including 43 males and 77 females.Collect basic patient data,including:age,sex,height,weight,body mass index,ASA score,anesthesia method,type of disease,etc.Collect perioperative blood test indicators,and the units of postoperative transfusion of red blood cell.The basic data of the two groups of patients were compared.After statistical analysis,the unevenly distributed factors of the two groups of patients were incorporated into the multivariate analysis model to reduce the confounding bias,and the influence of indwelling drainage on the perioperative period was analyzed.The total blood loss during the 4 days perioperative period was calculated by the Gross equation.The perioperative blood loss between the two groups was compared.The postoperative VAS score,the number of postoperative dressing changes,wound healing,Harris scores of patients 6 weeks after surgery,wound infection and deep vein thrombosis and other related complications were recorded.Results:The blood loss of patients were calculated by the Gross formula.The blood loss of patients in the non-drainage group was 0.941±0.307 L,and the blood loss of patients in the drainage group was 1.066±0.501 L.By comparing the basic data of the two groups of patients,statistical analysis found that the distribution of hip joint diseases are unevenly distributed.Incorporate drainage methods and types of hip joint diseases into a two-factor analysis model or perform stratified analysis based on types of hip joint diseases.Analyze the effects of drainage methods on total blood loss,VAS scores on the first and third days after surgery,the number of dressing changes after surgery,getting out of bed within two days after surgery,and Harris scores.The results of the analysis: the difference in perioperative blood loss between the two groups of patients was statistically significant(P<0.05).The perioperative blood loss of the drainage group was more than that of the non-drainage group.There was no significant difference in VAS scores between the two groups on the first postoperative day,and there was no statistical difference in VAS scores between the two groups on the third postoperative day.The difference in the number of postoperative changeing wound dressing between the two groups of patients was statistically significant(P<0.05).The number of changeing wound dressing in the drainage group was more than that in the non-drainage group.The difference in the number of people getting out of bed within two days after the operation was compared with the method of stratified analysis base on the types of hip joint diseases.The difference in the number of people getting out of bed within two days after the operation of the two groups of patients with femoral neck fracture was statistically significant.(P<0.05).The number of people getting out of bed within two days after the operation in the drainage group was less than that in the no-drainage group.There was no significant difference in the number of people getting out of bed within two days after the operation in patients with other hip joint diseases.There was no statistical difference in Harris score between the two groups.No complications such as wound infection,deepvein thrombosis and pulmonary embolism occurred during the operation and follow-up period.Conclusion:There is a statistical difference in the perioperative blood loss between the drainage group and the non-drainage group after total hip replacement.Drainage may increase the patient’s perioperative blood loss.The non-drainage group had fewer number of changeing wound dressing after surgery,and early postoperative functional exercise was earlier.Patients without a drainage tube perform early postoperative functional exercise earlier.The patient’s absence of drainage tube did not increase the possibility of postoperative incision and systemic complications.There was no significant difference in wound healing between the two groups,Harris score at 6 weeks postoperatively,and postoperative complications. |
