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膝关节单髁置换术后隐性失血的结果分析

摘要点击次数: 1852 全文下载次数: 1133 投稿时间：2017-07-13

作者	Author	单位	Address	E-Mail
张占丰	ZHANG Zhan-feng	湖州市第一人民医院, 浙江湖州 313000	The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
闵继康	MIN Ji-kang	湖州市第一人民医院, 浙江湖州 313000	The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China	mjk@medmail.com.cn
王丹	WANG Dan	湖州市第一人民医院, 浙江湖州 313000	The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
钟建明	ZHONG Jian-ming	湖州市第一人民医院, 浙江湖州 313000	The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China
李恒	LI Heng	湖州市第一人民医院, 浙江湖州 313000	The First People's Hospital of Huzhou, Huzhou 313000, Zhejiang, China

期刊信息：《中国骨伤》2017年，第30卷，第11期，第1013-1017页

DOI：10.3969/j.issn.1003-0034.2017.11.009

基金项目:

中文摘要:

目的：对膝关节单髁置换术后隐性失血量进行计算，通过与全膝置换术比较，分析其影响因素及其对术后功能的影响。

方法：对2012年7月至2015年7月收治的130例患者进行回顾性研究，其中膝关节单髁置换术65例，全膝置换术65例。膝关节单髁置换术组男27例，女38例；年龄50~82岁，平均（62.3±4.3）岁；其中>70岁14例，50~70岁51例；BMI指数18.3~30.1 kg/m²，平均（23.9±2.6） kg/m²。全膝置换术组男23例，女42例；年龄57~81岁，平均（67.4±4.9）岁；其中>70岁34例，50~70岁31例，BMI指数20.6~33.1 kg/m²，平均（25.6±2.3） kg/m²。根据Gross方程计算术后隐性失血，比较两组隐性失血量差异，并比较不同性别、年龄组之间差异，同时分析其与BMI指数、术后膝关节功能是否存在相关性。动态观察术后全血容量变化，比较两组之间的差异情况。

结果：膝关节单髁置换术组术后隐性失血量（375.25±168.09） ml，HSS评分87.11±5.39。全膝置换术组术后隐性失血量（898.81±221.47） ml，HSS评分82.23±3.08。两组隐性失血、HSS评分差异均有统计学意义（P<0.05）。各指标男女间、不同年龄段间差异无统计学意义，隐性失血量与术后HSS评分之间无明显相关性，隐性失血量与BMI指数之间无明显相关性。两组术后全血容量变化比较，术后第2、4、5天差异均有统计学意义。膝关节单髁置换术组没有患者接受术后同种异体输血，全膝置换术组3例接受术后同种异体输血。

结论：单髁置换术后隐性失血是总失血量的一个组成部分，其失血量较全膝置换术少，机体可对其进行代偿，不会增加术后输血风险。

【关键词】关节成形术,置换,膝失血,手术手术后并发症

Analysis on the occult blood loss after unicompartment knee arthroplasty

ABSTRACT

Objective: To calculate the volume of occult blood loss after unicompartment knee arthroplasty(UKA),and analyze its influential factors by comparing with total knee arthroplasty.

Methods: A retrospective study of 130 cases from July 2012 to July 2015 were enrolled,of which and 65 cases were UKA,and 65 cases were TKA. In UKA group there were 27 males and 38 females,and the mean age was (62.3±4.3) years old (ranged,50 to 82 years old). There were 14 cases older than 70 years old,while 51 cases among 50 to 70 years old. The mean Body mass index (BMI) was (23.9±2.6) kg/m²(ranged,18.3 to 30.1 kg/m²). In TKA group there were 23 males and 42 females,and the mean age was (67.4±4.9) years old (ranged,57 to 81 years old). There were 34 cases older than 70 years old,while 31 cases among 50 to 70 years old. The mean BMI was (25.6±2.3) kg/m²(ranged,20.6 to 33.1 kg/m²). Hidden blood loss was calculated according to Gross equation,and the differences between the two groups including different ages and genders were observed subsequently. The differences of red blood cell change between two groups were observed dynamically postoperatively.

Results: Postoperative hidden blood loss was (375.25±168.09) ml,HSS score was 87.11±5.39 in UKA group. Hidden blood loss was (898.81±221.47) ml,HSS score was 82.23±3.08 in TKA group. The differences between the two groups were significant. There were no significant differences in ages and genders. There were no significant relationship between hidden blood loss and HSS score or BMI,while the differences of red blood cell change were significant on the second day,the 4th day and the 5th day. There was no allogenic blood transfusion in UKA group,while 3 patients with transfusion in TKA group.

Conclusion: Hidden blood loss is part of total blood loss after UKA,and the volume in UKA is less than that in TKA. It could be compensated by the body and rarely affect the knee function. The hidden blood is not a risk factor of transfusion.

KEY WORDS Arthroplasty,replacement,knee Blood loss,surgical Postperative complications

引用本文，请按以下格式著录参考文献：

中文格式:	张占丰,闵继康,王丹,钟建明,李恒.膝关节单髁置换术后隐性失血的结果分析[J].中国骨伤,2017,30(11):1013~1017
英文格式:	ZHANG Zhan-feng,MIN Ji-kang,WANG Dan,ZHONG Jian-ming,LI Heng.Analysis on the occult blood loss after unicompartment knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(11):1013~1017

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