日本リウマチ・関節外科学会雑誌
Online ISSN : 1884-9059
Print ISSN : 0287-3214
ISSN-L : 0287-3214
人工膝関節置換術時に駆血帯を開放して行う止血操作の効果
山岡 茂雄幅田 孝平岡 修治上松 耕太高倉 義典
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2002 年 21 巻 2 号 p. 169-174

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Objective : A study was conducted to evaluate the effect of intraoperative tourniquet hemostasis with intermittent release on blood loss and autologous transfusion volume in patients undergoing total knee arthroplasty (TKA) .
Methods : The volumes of blood loss and autologous transfusion were measured in 44 patients during TKA surgery. The patients were classified into two groups : Group A, 27 patients in whom blood was staunched intraoperatively with a releasing tourniquet, and Group B, 17 patients in whom blood was staunched intraoperatively with constant tourniquet compression, followed by postoperative tourniquet release and application of a compressive dressing.
Results : The volumes of intraoperative blood loss and total blood loss in group A were significantly larger than those in group B, and there was a correlation between the volume of postoperative blood loss and that of autologous transfusion.
These results show that intraoperative hemostasis with a releasing tourniquet does not decrease postoperative blood loss.
Conclusion : To avoid homologous transfusion, TKA should be performed under constant tourniquet compression, and autologous transfusion should be adopted to adjust for any postoperative blood loss.
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