_人工关节置换术后隐性失血的相关分析.pdf.docVIP

中国组织工程研究与临床康复 第 12 卷 第 4 期 2008–01–22 出版 Journal of Clinical Rehabilitative Tissue Engineering Research January 22, 2008 Vol.12, No.4 临床医学 人工关节置换术后隐性失血的相关分析★ 肖 鹏，吴学建，刘宏建 Hidden blood loss after hip and knee arthroplasty  Xiao Peng, Wu Xue-jian, Liu Hong-jian Abstract AIM: Hidden blood loss could greatly affect the recovery of total hip arthroplasty (THA) and total knee arthroplasty (TKA), especially the decrease in hemoglobin after TKA. In this study, the correlated mechanisms and clinical effect of hidden blood loss after THA and TKA were investigated. METHODS: ①From March 2001 to May 2005, 41 patients (22 males and 19 females, aged 61-79 years) treated with THA and 37 patients (23 males and 14 females, aged 65-77 years) treated with TKA were selected. All arthroplasties were primary and unilateral, and the 24 hours fluid resuscitation was less than 2 000 mL. The informed consent was obtained from the subjects. ②Thirty-two of 41 patients undergoing THA received allogeneic store blood during and after operation. All patients undergoing TKA were given pueumatic tourniquet during operation but no blood transfusion. Blood routine examination was performed before and 2-3 days after operation to record haematocrit (Hct). Meanwhile, the body mass index (BMI) of all patients was calculated preoperatively. People with BMI ≤ 30 kg/m2 served as non-obesity group and 30 kg/m2 served as obesity group. Using Gross formula, the true total blood loss was calculated depending on the height, body mass and pre-and post-operative Hct, and hidden blood loss was gotten by subtracting the visible blood loss from total loss. ③The correlation between visible and hidden blood loss was observed. RESULTS: All 41 patients undergoing THA and 37 TKA were involved in the result analysis. ①Following THA, the mean total loss was 1 520 mL and the hidden blood loss 482 mL (32%). Following TKA, the mean total loss was 1 508 mL and the hidden blood loss was 776 mL (52%). The hidden