실리콘 링 지혈대 사용은 대퇴골 원위부 골절의 최소 침습적 잠김 금속판 고정술 시 출혈을 줄이는 데 도움이 되는가 = Does the Use of a Silicone Ring Tourniquet Help Reduce Bleeding in the Minimally Invasive Internal Fixation with Locking Plate for Distal Femoral Fractures?

다국어 초록 (Multilingual Abstract)

Purpose: This study evaluated the usefulness of a silicone ring tourniquet by analyzing the changes in the perioperative hemoglobin (Hb) levels or amount of perioperative bleeding compared to those of a pneumatic tourniquet or no usage during minimally invasive plate fixation for distal femoral fractures.
Materials and Methods: From January 2017 to December 2019, 30 patients who underwent minimally invasive plate fixation using a locking compression plate for distal femoral fractures were evaluated and classified as a silicone ring tourniquet (Group 1), a pneumatic tourniquet (Group 2), and no usage (Group 3). The variables for analysis were age, sex, preoperative Hb (preHb), postoperative 72-hour Hb (postHb), differences between preHb and postHb (preHb-postHb), amount of intraoperative and overall transfusion, estimated unit of transfusion corrected by preHb-postHb and total transfusion (Hb-lost), amount of intraoperative and postoperative and total bleeding. One-way ANOVA was used to identify the differences between the groups.
Results: The age, sex, operation time, preHb, preHb-postHb, amount of intraoperative and overall transfusion and Hb-lost were similar in the two groups. The amount of intraoperative bleeding was significantly lower in Group 1 than Group 3 (p=0.004), but there was no difference in the amount of postoperative and total bleeding between the two groups.
Conclusion: The use of a silicone ring tourniquet in the minimally invasive plate fixation for distal femoral fractures decreased the amount of intraoperative bleeding compared to no use of a tourniquet.

국문 초록 (Abstract)

목적: 대퇴골 원위부 골절에 대해 최소 침습적 금속판 고정술을 시행하는 경우, 실리콘 링 지혈대의 사용이 혈색소 변화나출혈량에 영향을 주는지 알아보고자 하였다.
대상 및 방법: 2017년 1월부터 2019년 12월까지 대퇴골 원위부 골절로 최소 침습적 잠김 압박 금속판을 이용한 고정술을받은 30명의 환자를 실리콘 링 지혈대(1군), 공기압 지혈대(2 군), 지혈대 미사용(3군)으로 분류하였다. 나이, 성별, 수술 시간, 혈색소 수치, 수혈량, 술 전후 혈색소와 수혈량으로 보정된 출혈량, 실제 출혈량을 분석하였고, 일원배치 분산분석을이용하여 각 군의 차이를 알아보았다.
결과: 세 군의 나이, 성별, 수술 시간, 술 전 혈색소, 술 전후 혈색소 차이, 수혈량, 술 전후 혈색소와 수혈량으로 보정된 출혈량은 차이가 없었다. 술 중 출혈량은 3군 대비 1군에서 유의하게 낮았지만(p=0.004), 술 후 및 전체 출혈량은 세 군 간 차이가 없었다.
결론: 대퇴골 원위부 골절의 최소 침습적 금속판 고정술 시실리콘 링 지혈대의 사용은 지혈대 미사용에 비해 수술 중 출혈량을 감소시켰으나, 술 전후 혈색소 차이나 수혈량, 전체 출혈량에서 유의한 차이는 없었다.

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