슬관절 인공관절 치환술 후 배액관의 위치에 따른 출혈량 및 임상결과 비교 (A Comparative Study of Subcutaneous versus Intra-Articular Indwelling Closed Suction Drainage after Total Knee Arthroplasty)

서지정보

· 발행기관 : 대한정형외과학회
· 수록지 정보 : 대한정형외과학회지 / 50권 / 4호 / 313 ~ 319페이지
· 저자명 : 최영준, 이기원, 이현일, 조완종, 황도연, 심상준, 조형권

초록

목적: 슬관절 인공관절 전치환술 후 배액관의 위치에 따른 외부 배액량, 혈액 손실량 및 임상 결과를 비교하고자 하였다.
대상 및 방법: 양측 슬관절 인공관절 전치환술을 같은 날 동시에 시행받은 환자 100명을 대상으로, 실험 1에서는 50명에서 편측은관절강 내에, 반대측은 피하지방층에 배액관을 삽입하여 수술 후 외부 배액량과 통증 정도, 관절 운동 범위, 합병증의 빈도를 비교하였다. 실험 2에서는 또 다른 50명에서 양측 모두 관절강 내에 배액관을 삽입하여 총 혈액 손실량을 산출하여 실험 1의 환자 50명과비교하였다.
결과: 실험 1에서 외부 배액량은 피하지방층에 배액관을 삽입한 군이 관절강 내에 삽입한 군보다 유의하게 적었으나(p＜0.001), 통증의 정도는 수술 후 2일경에만 두 군 간 유의한 차이를 보였다. 실험 2에서 총 혈액 손실량을 비교했을 때 두 군 간 유의한 차이를 보이지 않았다.
결론: 피하지방층에 배액관을 삽입한 군의 외부 배액량은 관절강 내에 삽입한 군보다는 적었으나 배액관의 삽입 위치에 따른 총 혈액 손실량은 유의한 차이를 보이지 않았으며 임상 결과의 큰 차이가 없어 피하지방층에 배액관 삽입의 큰 이점은 관되찰지 않았다.

영어초록

Purpose: The aim of this study was to compare the drainage amount, total blood loss, and clinical results between two different positions of suction drainage after total knee arthroplasty.
Materials and Methods: A total of 100 patients who underwent one stage bilateral total knee arthroplasty were enrolled. In experiment 1 with 50 patients, we compared the drainage amount, pain, range of motion, and complications of the leg whose suction drain was inserted into the joint cavity with those of the contralateral leg whose suction drain was inserted in subcutaneous tissue. Another 50 patients of experiment 2 had suction drainage in the joint cavity of both legs and the total blood loss (sum of drainage output, exudates, and hematoma of subcutaneous tissue and joint) was calculated and compared with that of experiment 1.
Results: In experiment 1, the drainage amount was less in the leg with suction drainage in subcutaneous tissue compared with the contralateral leg with suction drainage in the joint cavity (p<0.001). However, the postoperative joint pain was significantly different only on post-operative day 2 between two legs. In experiment 2, there was no significant difference in the total blood loss between the two groups.
Conclusion: Although the drainage amount was less in the leg whose suction drain was kept in subcutaneous tissue compared with the contralateral leg whose suction drain was in the joint cavity, the total blood loss and the clinical results were not significantly different according to the position of the suction drain. Therefore, we can conclude that the subcutaneous position of the suction drain did not yield superior results.

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