目的探讨改良的局部加压包扎法治疗腹股沟区切口淋巴瘘的疗效。方法2005年12月至2010年11月期间对10例腹股沟区切口淋巴瘘患者采用弹力绷带持续加压包扎,同时切口放置闭式引流装置进行治疗。 结果全部患者切口经加压包扎后淋巴液均明显减少,经持续加压包扎3~20 d(平均7.2 d)后获临床治愈; 其中1例患者于加压包扎后第4天出现下肢股浅静脉血栓,经及时溶栓和抗凝治疗后好转。 本组患者随访1~59个月(平均14.7个月),10例患者切口均一期愈合,无下肢淋巴水肿发生。结论弹力绷带加压包扎结合切口闭式引流治疗腹股沟区切口淋巴瘘疗效显著,该方法简单、安全,值得临床推广应用。
ObjectiveTo investigate the hemostasis effect of compression dressing therapy after total hip arthroplasty (THA). MethodThirty-four patients undergoing unilateral THA between December 2014 and March 2015 were randomly divided into observation group (compression dressing group, n=17) and control group (ordinary dressing group, n=17) . There was no significant difference in gender, age, height, weight, lesion hips, pathogeny, disease duration, and preoperative hemoglobin between 2 groups (P>0.05) . The total blood loss theoretical value, the postoperative drainage volume, the visible blood loss, the hidden blood loss, the total blood transfusion volume, the number of patients receiving blood transfusion, and the related complications were compared between 2 groups. ResultsNo significant difference was found in operation time and hospitalization time between 2 groups (t=0.337, P=0.738; t=0.140, P=0.889) . The incisions healed by first intention in all patients. Six cases had incision subcutaneous hematoma in the control group, no incision subcutaneous hematoma occurred in the observation group (χ2=7.286, P=0.018) . No postoperative complications of wound superficial infection and venous thrombosis occurred in 2 groups. After operation, blood transfusion was given in 1 case of observation group and 7 cases of control group, showing significant difference (χ2=5.885, P=0.039) , and the total blood transfusion volume was 600 mL and 3 200 mL, respectively. There was no significant difference in preoperative blood volume and intraoperative blood loss between 2 groups (P>0.05) , but the total blood loss theoretical value, the postoperative drainage volume, the visible blood loss, and the hidden blood loss in observation group were significantly less than those in control group (P<0.05) . ConclusionsThe compression dressing should be performed after THA because it can effectively reduce postoperative blood loss and the incidence of wound hematoma.