中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2012年
7期
654-657
,共4页
曹国平%边红光%胡建鑫%汪灿峰
曹國平%邊紅光%鬍建鑫%汪燦峰
조국평%변홍광%호건흠%왕찬봉
关节成形术,置换,髋%手术后出血
關節成形術,置換,髖%手術後齣血
관절성형술,치환,관%수술후출혈
Arthroplasty,replacement,hip%Postoperative hemorrhage
目的 分析初次人工全髋关节置换术(total hip arthroplasty,THA)后隐性失血的情况并提出处理对策.方法 回顾性分析2009年1月-2011年1月采用THA治疗单侧需要进行初次置换的髋部疾病138例患者,其中男48例,女90例；年龄45-71岁,平均62岁.对患者术前、术后血常规及术中、术后出血、输血情况进行分析,对患者围术期隐性出血情况进行评估.结果 本组138例患者全部进行术中自体血回输,术中出血量(495±105)ml,术后引流量(121±29)ml,其中116例术后另予输红细胞悬液及血浆以提高血色素水平,输红细胞悬液量(600±225)ml.本组总失血量(1521±156)ml,隐性失血量(822±96)ml,隐性失血量占总失血量57.2％.各指标男女间差异均无统计学意义.结论 隐性失血是影响进行THA患者预后的一个重要因素,进行此类手术评估出血量时应充分考虑到隐性失血量,及时采取相应的处理措施充分有效地恢复患者有效循环血量,以保证围术期安全度过,以利患者的康复.
目的 分析初次人工全髖關節置換術(total hip arthroplasty,THA)後隱性失血的情況併提齣處理對策.方法 迴顧性分析2009年1月-2011年1月採用THA治療單側需要進行初次置換的髖部疾病138例患者,其中男48例,女90例；年齡45-71歲,平均62歲.對患者術前、術後血常規及術中、術後齣血、輸血情況進行分析,對患者圍術期隱性齣血情況進行評估.結果 本組138例患者全部進行術中自體血迴輸,術中齣血量(495±105)ml,術後引流量(121±29)ml,其中116例術後另予輸紅細胞懸液及血漿以提高血色素水平,輸紅細胞懸液量(600±225)ml.本組總失血量(1521±156)ml,隱性失血量(822±96)ml,隱性失血量佔總失血量57.2％.各指標男女間差異均無統計學意義.結論 隱性失血是影響進行THA患者預後的一箇重要因素,進行此類手術評估齣血量時應充分攷慮到隱性失血量,及時採取相應的處理措施充分有效地恢複患者有效循環血量,以保證圍術期安全度過,以利患者的康複.
목적 분석초차인공전관관절치환술(total hip arthroplasty,THA)후은성실혈적정황병제출처리대책.방법 회고성분석2009년1월-2011년1월채용THA치료단측수요진행초차치환적관부질병138례환자,기중남48례,녀90례；년령45-71세,평균62세.대환자술전、술후혈상규급술중、술후출혈、수혈정황진행분석,대환자위술기은성출혈정황진행평고.결과 본조138례환자전부진행술중자체혈회수,술중출혈량(495±105)ml,술후인류량(121±29)ml,기중116례술후령여수홍세포현액급혈장이제고혈색소수평,수홍세포현액량(600±225)ml.본조총실혈량(1521±156)ml,은성실혈량(822±96)ml,은성실혈량점총실혈량57.2％.각지표남녀간차이균무통계학의의.결론 은성실혈시영향진행THA환자예후적일개중요인소,진행차류수술평고출혈량시응충분고필도은성실혈량,급시채취상응적처리조시충분유효지회복환자유효순배혈량,이보증위술기안전도과,이리환자적강복.
Objective To analyze the hidden blood loss following primary total hip arthroplasty (THA) and put forward corresponding treatment measures.Methods A retrospective study was done on the 138 patients with hip disease managed with THA for the preliminary unilateral replacement from January 2009 to January 2011.There were 48 males and 90 females,at age range of 45-71 years (mean,62 years).The pre-and post-operative blood routine and intra-and post-operative blood loss and transfusion were analyzed and hidden blood loss during peri-operation period was evaluated.Results All the patients were trnsfused with autologous blood intra-operatively.Intra-operative blood loss was (495 ± 105) ml and postoperative drainage volume was ( 121 ±29) ml.In addition,116 patients were given red cell suspension (RCS) and blood plasma to raise the level of hemoglobin and the RCS transfusion volume was (600 ± 225) ml.The total blood loss was (1 521 ±156) ml including hidden blood loss of (822 ±96) ml (57.2％).No obvious differences were observed in the indicators between males and females.Conclusions Hidden blood loss is an important factor that affects the prognosis of the patients treated by THA.In order to secure their safety in perioperative period and benefit their recovery,assessment of the amount of bleeding in THA should fully take the hidden blood loss into consideration and prompt treatment measures should be taken to fully and effectively recover their effective circulation blood volume.
