中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
35期
6234-6239
,共6页
石士平%李伟%张伟%孙水%王超%李会波
石士平%李偉%張偉%孫水%王超%李會波
석사평%리위%장위%손수%왕초%리회파
骨关节植入物%人工假体%膝关节%骨性关节炎%分级%人工关节置换%隐性失血%失血量
骨關節植入物%人工假體%膝關節%骨性關節炎%分級%人工關節置換%隱性失血%失血量
골관절식입물%인공가체%슬관절%골성관절염%분급%인공관절치환%은성실혈%실혈량
bone and joint implants%spinal implants%artificial prosthesis%knee joint%knee osteoarthritis%classification%arthroplasty%hidden hemorrhage%blood loss
背景：人工膝关节置换的对象群体年龄偏高，常伴有高血压病、糖尿病等基础性疾病，身体条件较差，所以围置换期失血成为影响置换安全的重要影响因素。<br> 目的：分析初次行人工膝关节置换围置换期的隐性失血量，以及根据膝骨性关节炎严重程度对围置换期出血量进行置换前评估的方法。<br> 方法：对行人工膝关节置换的膝骨性关节炎患者126例进行回顾性分析，根据Kel gren和Lawrecne影像学分级把患者分为Ⅲ级组与Ⅳ级组，对两组患者的隐性失血量进行统计学分析。<br> 结果与结论：纳入患者平均总失血量1560 mL，其中隐性失血量865 mL(55%)，Ⅲ级组平均总失血量1290 mL，其中隐性失血量684 mL (占总失血量53%)，Ⅳ级组平均总失血量1644 mL，其中隐性失血量921 mL(占总失血量56%)，对两组数据进行统计学分析比较，在平均总失血量与隐性失血量上差异有显著性意义(P<0.05)，而在隐性失血所占比例上差异无显著性意义。结果提示膝骨性关节炎影像学分级等级越高，人工全膝关节置换围置换期平均总失血量和隐性失血量越大，而隐性失血的比例变化不明显。对不同严重程度的膝骨性关节炎患者进行关节置换前出血量预测评估，对加强患者围置换期血液管理及保证患者生命安全有积极意义。
揹景：人工膝關節置換的對象群體年齡偏高，常伴有高血壓病、糖尿病等基礎性疾病，身體條件較差，所以圍置換期失血成為影響置換安全的重要影響因素。<br> 目的：分析初次行人工膝關節置換圍置換期的隱性失血量，以及根據膝骨性關節炎嚴重程度對圍置換期齣血量進行置換前評估的方法。<br> 方法：對行人工膝關節置換的膝骨性關節炎患者126例進行迴顧性分析，根據Kel gren和Lawrecne影像學分級把患者分為Ⅲ級組與Ⅳ級組，對兩組患者的隱性失血量進行統計學分析。<br> 結果與結論：納入患者平均總失血量1560 mL，其中隱性失血量865 mL(55%)，Ⅲ級組平均總失血量1290 mL，其中隱性失血量684 mL (佔總失血量53%)，Ⅳ級組平均總失血量1644 mL，其中隱性失血量921 mL(佔總失血量56%)，對兩組數據進行統計學分析比較，在平均總失血量與隱性失血量上差異有顯著性意義(P<0.05)，而在隱性失血所佔比例上差異無顯著性意義。結果提示膝骨性關節炎影像學分級等級越高，人工全膝關節置換圍置換期平均總失血量和隱性失血量越大，而隱性失血的比例變化不明顯。對不同嚴重程度的膝骨性關節炎患者進行關節置換前齣血量預測評估，對加彊患者圍置換期血液管理及保證患者生命安全有積極意義。
배경：인공슬관절치환적대상군체년령편고，상반유고혈압병、당뇨병등기출성질병，신체조건교차，소이위치환기실혈성위영향치환안전적중요영향인소。<br> 목적：분석초차행인공슬관절치환위치환기적은성실혈량，이급근거슬골성관절염엄중정도대위치환기출혈량진행치환전평고적방법。<br> 방법：대행인공슬관절치환적슬골성관절염환자126례진행회고성분석，근거Kel gren화Lawrecne영상학분급파환자분위Ⅲ급조여Ⅳ급조，대량조환자적은성실혈량진행통계학분석。<br> 결과여결론：납입환자평균총실혈량1560 mL，기중은성실혈량865 mL(55%)，Ⅲ급조평균총실혈량1290 mL，기중은성실혈량684 mL (점총실혈량53%)，Ⅳ급조평균총실혈량1644 mL，기중은성실혈량921 mL(점총실혈량56%)，대량조수거진행통계학분석비교，재평균총실혈량여은성실혈량상차이유현저성의의(P<0.05)，이재은성실혈소점비례상차이무현저성의의。결과제시슬골성관절염영상학분급등급월고，인공전슬관절치환위치환기평균총실혈량화은성실혈량월대，이은성실혈적비례변화불명현。대불동엄중정도적슬골성관절염환자진행관절치환전출혈량예측평고，대가강환자위치환기혈액관리급보증환자생명안전유적겁의의。
BACKGROUND:The patients receiving total knee arthroplasty are high in average age, and often accompanied with hypertension, diabetes and other basic diseases. Due to the poor physical conditions of the patients, <br> perioperative hemorrhage becomes the important factor that affecting the safety of replacement. <br> OBJECTIVE:To analyze perioperative hidden hemorrhage of primary total knee arthroplasty, and to explore the method of evaluating perioperative blood loss by osteoarthritis severity before total knee arthroplasty. <br> METHODS:A retrospective analysis of 126 knee osteoarthritis patients undergoing total knee arthroplasty was conducted. Al the patients were divided into two groups according to Kel gren and Lawrecne imaging classification:stage Ⅲ group and stage Ⅳ group. The hidden hemorrhage of the patients in two groups was calculated. <br> RESULTS AND CONCLUSION:The average total blood loss of the patients was 1 560 mL, included hidden hemorrhage 865 mL (55%). The mean blood loss of stage Ⅲ group was 1 290 mL with the mean hidden <br> hemorrhage of 684 mL (53%). The mean blood loss of stage Ⅳ group was 1 644 mL with the mean hidden <br> hemorrhage of 921 mL (56%). Statistical analysis showed there were significant differences of total blood loss and hidden hemorrhage between two groups (P<0.05), but there was no significant difference in the percentage of <br> hidden hemorrhage. The results indicate that higher grade of osteoarthritis imaging classification, the more of total blood loss and hidden hemorrhage, while the change of the percentage of hidden hemorrhage is not significant. Preoperative evaluation of patients’ blood loss by osteoarthritis severity has great significance for blood <br> management and surgical safety of patients.
