中文摘要：

目的探讨全膝关节置换术中分时段应用止血带的疗效和安全性。方法选取2010—2012年在某院初次进行全膝关节置换术的患者80例，通过计算机随机分组的方式，将其随机分为试验组和对照组，每组40例，试验组患者术中使用止血带的时机为截骨开始至结束，对照组则是在整个术中全程使用止血带，比较两组患者的术中各项重要指标，术后1，3，5d血红蛋白量及RBC计数，以及两组患者术后并发症发生情况。结果试验组患者的手术时间、术中出血量分别为（136．7±18．6）min，（167．8±16．8）ml，对照组分别为（138．6±19．4）rain，（174．8±14．6）m1，两组比较，差异无统计学意义（t分别为0，447，1．989；P〉0．05），试验组患者术后1，3，5d血红蛋白值分别为（7．6±0．8），（15．9±1．1），（16．3±1．3）g／L，对照组分别为（7．9±0．7），（16．4±1．2），（16．8±1．1）g／L，两组比较，差异无统计学意义（t分别为1．785，1．943，1．857；P〉0．05），试验组患者术后1，3，5dRBC计数分别为（0．18±0．02），（1．23±0．22），（1．58±0．39）×1012／L，对照组分别为（0．19±0．03），（1．34±0．28），（1．74±0．42）×1012／L，两组比较，差异无统计学意义（t分别为1．754，1．954，1．766；P〉0．05）。对照组并发症发生率为52．5％，其中深静脉血栓6例，Ⅱ期愈合伤口感染4例，膝关节血肿7例，腓总神经损伤4例。试验组并发症发生率为5．0％，其中深静脉血栓1例，膝关节血肿1例，试验组低于对照组，差异有统计学意义（X2=22．029，P〈0．05）。结论全膝关节置换术时分中段应用止血带，术后患者的并发症较少，有利于患者的预后。

英文摘要：

Objective To explore the effect and safety of using tourniquet to patients during differenttime interval of total knee arthroplasty. Methods A total of 80 cases of patients, who had total knee arthroplasty at our hospital from 2010 to 2012, were divided into the experimental group and the control group randomly, according to the computer random grouping method, 40 cases each. The patients in the experimental group were used the tourniquet method when the osteotomy began. The tourniquet was used to the control group during the whole operation process. Various intraoperative indexes were compared between groups ： hemoglobin content （ 1, 3 and 5 day postoperatively）, red blood cell count and postoperative complications. Results The operation time and lose of blood volume of patients in the experimental group were （136.7 ± 18.6） min and （167.8 ± 16.8 ） ml. The operation time and lose of blood volume of patients in the control group were （138.6 ± 19.4） min and （ 174.8 ± 14.6） ml. There were no significant differences between these two groups of patients （ t = 0. 447, 1. 989, respectively; P 〉 0.05 ）. The hemoglobin content of 1,3 and 5 days postoperatively of the experimental group were （7.6 ± 0.8 ）, （ 15.9 ± 1. 1 ） and （ 16.3 ~ 1.3 ） g/L, respectively. The hemoglobin content of 1, 3 and 5 days postoperatively of the control group were （7.9 ± 0.7 ）, （ 16.4 ± 1.2 ） and （ 16.8 ± 1.1 ） g/L, respectively. The comparison between groups were without statistical differences （ t = 1. 785, 1. 943, 1. 857, respectively; P 〉 0.05 ）. The red blood cell count of 1, 3 and 5 days postoperatively of the experimental group were （0. 18 20.02）, （1.23 20.22） and （1.58 ±0.39） ×1012/L, respectively. The red blood cell count of 1, 3 and 5 days postoperatively of the control group were （0. 19 ~ 0.03）, （ 1.34 ±0.28 ） and （ 1.74 ± 0.42） × 1012/L, respectively. The comparison between groups were without statistical differences （t = 1. 754, 1. 954,