摘要
目的 研究全膝关节置换术（total knee arthroplasty,TKA）后隐性失血的特点及影响因素,为临床工作提供参考依据. 方法对75例因膝关节骨性关节炎行初次单侧TKA患者（男21例,女54例;平均年龄68.7岁）进行回顾性分析;应用Gross方程推算隐性失血量.分析性别、术中是否松止血带止血、是否应用自体引流血回输等因素对TKA术后隐性失血量的影响. 结果 本组围术期总失血量（1 551.3±369.6）ml,隐性失血量（792.3±228.6）ml.男性患者的隐性失血量高于女性（P＜0.05）;术中松止血带止血能减少隐性失血量（P＜0.05）;应用自体引流血回输对隐性失血量无显著影响. 结论取术后红细胞压积（Hct）的最低值（行异体输血的患者选输血后的最低值）作为参数计算隐性失血量更具有代表性.男女患者之间的相对隐性失血量差异无统计学意义;术中松止血带止血可减少隐性失血量,但对围术期总失血量不产生影响.术后自体引流血回输并不影响围术期总失血量和隐性失血量,但可降低异体血输血率.
Objective To study the characteristic and influential factor of the hidden blood loss after total knee arthroplasty （TKA） so as to provide a reference frame for clinical work. Methods There were 75 patients with osteoarthritis of the knee who were operated with unilateral primary TKA. The patients including 21 males and 54 females at a mean age of 68.7 years were retrospectively analyzed.The perioperative blood loss and the hidden blood loss following TKA were calculated by Gross formula. It was analyzed that if the perioperative blood loss and the hidden blood loss following TKA were affected by gender, haemostasis during operation with deflating tourniquet and reinfusion of the drained blood. Results The preoperative blood loss was （1551.3 ± 369.6） ml and the hidden blood loss was （792.3 ±228.6） ml. The hidden blood loss of male was significantly higher than that of female （P 〈 0.05）. The hidden blood loss was reduced by haemostasis during operation with deflating tourniquet （P 〈 0.05） but was not affected by postoperative shed blood reinfusion. Conclusions The lowest value of Hct is a representative parameter for calculation of the hidden blood loss. There is no significant difference between male and female about the relative hidden blood loss. Haemostasis during operation with deflating tourniquet can reduce teh hidden blood loss but not affect the total perioperative blood loss. Reinfusion of the drained blood can reduce the transfusion rate but does not affect the total preoperative blood loss and the hidden blood loss.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2010年第9期831-834,共4页
Chinese Journal of Trauma
关键词
关节成形术
置换
膝
出血
手术后
Arthroplasty,replacement,knee
Postoperative hemorrhage
