中文摘要：

背景：人工全膝关节置换作为膝骨关节炎晚期患者缓解疼痛、重建膝关节功能的最终修复方案,已被人们普遍接受。但置换后放置引流管与否一直存在很大争议。目的：比较初次单侧人工全膝关节置换后膝关节腔内放置引流管与否的修复效果差异。方法：选择行初次单侧人工全膝关节置换的患者102例为研究对象,随机分为2组。引流组在关闭切口前放置引流管,非引流组则直接关闭切口不放置引流管。分别记录2组置换前及置换后1,3,7 d血红蛋白及红细胞压积值,计算总失血量,评估失血情况;观测患肢置换后疼痛目测类比评分、肿胀程度、皮肤瘀斑面积、感染以及下肢深静脉血栓形成等并发症;记录置换后1年时美国膝关节协会评分。对2组患者的观测指标进行对比分析。结果与结论：①置换后引流组总失血最及异体血输血率冠著高于非引流纰，荠异有艟著性意义（P〈0.05）.②置换后2组患者患膝目测类比疼痛评分、肿胀程度、皮肤瘀斑面积、感染以及下肢深静脉血栓发生率差异均无显著性意义（P〉0．05）：③美国膝关节协会评分2组差异未见显著性意义（P〉0．05）；④结果表明，人工全膝关节置换后膝关节腔内不放置引流管将降低患者置换后的失咀精及异体输血率，并不增加置换后肢体肿胀程度及皮肤瘀斑面积。在感染、下肢深静脉血栓发生牢及膝关节功能方面放与不放置引流管亦无差异。故全膝关节置换后关节腔内不放置引流管相对安全，并无明显不良后果。

英文摘要：

BACKGROUND：Total knee arthroplasty had been generally accepted as the final treatment plan,relieving pain and reconstructing function of knee joint.However,whether drainage tube can be used after replacement is still controversial.OBJECTIVE：To compare the clinical effects of drainage versus nondrainage after primary unilateral total knee arthroplasty.METHODS：Total 102 patients undergoing primary unilateral total knee arthroplasty were randomly divided into 2 groups.In the drainage groiup,a drainage tube was used.In the nondrainage group,drainage tube was not used.Total blood loss was calculated by recording the hemoglobin and hematocrit before operation and that after 1,3,7 days of operation.The pain visual analogue scale scores,arthrocele,ecchymosis,infection rate,and deep venous thrombosis of lower extremity were examined and analyzed postoperatively.Knee Society Scores were recorded at 1 year postoperatively.Above indexes were compared between the two groups.RESULTS AND CONCLUSION：（1） Total blood loss and blood transfusion rate were significantly higher in the drainage group than in the nondrainage group（P〈0.05）.（2） There was no statistically significant difference in the pain visual analogue scale scores,arthrocele,ecchymosis,infection rate,and deep venous thrombosis of lower extremity between the two groups after replacement（P〉0.05）.（3） No significant difference in Knee Society Scores was detected between the two groups（P〉0.05）.（4） Results indicated that the total blood loss and blood transfusion rate may decrease significantly in patients without wound drainage after total knee arthroplasty.Limb swelling and ecchymosis area were not increased.No significant difference in infection,deep venous thrombosis of lower extremity and knee function was detectable between the two groups.Thus,total knee arthroplasty without wound drainage is safe and does not have obvious adverse consequences.