中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
13期
1974-1978
,共5页
徐海永%张明%方怀玺%乐国平
徐海永%張明%方懷璽%樂國平
서해영%장명%방부새%악국평
植入物%人工假体%隐性失血%全髋关节置换%因素分析
植入物%人工假體%隱性失血%全髖關節置換%因素分析
식입물%인공가체%은성실혈%전관관절치환%인소분석
Arthroplasty,Replacement,Hip%Factor Analysis,Statistical%Blood Loss,Surgical
背景：隐性失血在全髋关节置换围手术期失血量中占较大比例，可严重影响关节功能的恢复，目前其具体影响因素及机制尚不明确。目的：通过对初次全髋关节置换患者的失血情况评价置换后隐性失血的相关影响因素，并分析隐性失血量与患者预后的相关性。方法：回顾性分析2011年4月至2013年4月110例在柳州市工人医院接受初次全髋关节置换患者的临床资料，根据 ward 和 Gross 的方法计算隐性失血量，分析性别、年龄、体质量指数、假体类型、内科疾病、不同病因等对置换后隐性失血的影响。并按隐性失血量分为高失血组(≥480 mL)和低失血组(<480 mL)，置换后随访1年，采用Harris髋关节评分系统评估两组患者髋关节功能恢复情况，并对隐性出血量与关节功能恢复效果的相关性进行Pearson相关性分析。结果与结论：接受初次全髋关节置换后患者总失血量为(1340±367) mL，隐性失血量为(748±324) mL，占总量的53.7%。假体类型、内科疾病、不同病因与全髋关节置换后隐性失血量有显著相关性(P<0.05)，性别、年龄、体质量指数、手术时间与全髋关节置换后隐性失血量无显著相关性(P>0.05)。隐性失血量和置换后功能恢复有相关性(P=0.046)。提示假体类型、内科疾病、不同病因是全髋关节置换后隐性失血量的主要影响因素，隐性失血量对患者置换后关节功能恢复有一定影响。
揹景：隱性失血在全髖關節置換圍手術期失血量中佔較大比例，可嚴重影響關節功能的恢複，目前其具體影響因素及機製尚不明確。目的：通過對初次全髖關節置換患者的失血情況評價置換後隱性失血的相關影響因素，併分析隱性失血量與患者預後的相關性。方法：迴顧性分析2011年4月至2013年4月110例在柳州市工人醫院接受初次全髖關節置換患者的臨床資料，根據 ward 和 Gross 的方法計算隱性失血量，分析性彆、年齡、體質量指數、假體類型、內科疾病、不同病因等對置換後隱性失血的影響。併按隱性失血量分為高失血組(≥480 mL)和低失血組(<480 mL)，置換後隨訪1年，採用Harris髖關節評分繫統評估兩組患者髖關節功能恢複情況，併對隱性齣血量與關節功能恢複效果的相關性進行Pearson相關性分析。結果與結論：接受初次全髖關節置換後患者總失血量為(1340±367) mL，隱性失血量為(748±324) mL，佔總量的53.7%。假體類型、內科疾病、不同病因與全髖關節置換後隱性失血量有顯著相關性(P<0.05)，性彆、年齡、體質量指數、手術時間與全髖關節置換後隱性失血量無顯著相關性(P>0.05)。隱性失血量和置換後功能恢複有相關性(P=0.046)。提示假體類型、內科疾病、不同病因是全髖關節置換後隱性失血量的主要影響因素，隱性失血量對患者置換後關節功能恢複有一定影響。
배경：은성실혈재전관관절치환위수술기실혈량중점교대비례，가엄중영향관절공능적회복，목전기구체영향인소급궤제상불명학。목적：통과대초차전관관절치환환자적실혈정황평개치환후은성실혈적상관영향인소，병분석은성실혈량여환자예후적상관성。방법：회고성분석2011년4월지2013년4월110례재류주시공인의원접수초차전관관절치환환자적림상자료，근거 ward 화 Gross 적방법계산은성실혈량，분석성별、년령、체질량지수、가체류형、내과질병、불동병인등대치환후은성실혈적영향。병안은성실혈량분위고실혈조(≥480 mL)화저실혈조(<480 mL)，치환후수방1년，채용Harris관관절평분계통평고량조환자관관절공능회복정황，병대은성출혈량여관절공능회복효과적상관성진행Pearson상관성분석。결과여결론：접수초차전관관절치환후환자총실혈량위(1340±367) mL，은성실혈량위(748±324) mL，점총량적53.7%。가체류형、내과질병、불동병인여전관관절치환후은성실혈량유현저상관성(P<0.05)，성별、년령、체질량지수、수술시간여전관관절치환후은성실혈량무현저상관성(P>0.05)。은성실혈량화치환후공능회복유상관성(P=0.046)。제시가체류형、내과질병、불동병인시전관관절치환후은성실혈량적주요영향인소，은성실혈량대환자치환후관절공능회복유일정영향。
BACKGROUND:The hidden blood loss, accounted for a fairly large proportion of perioperative blood loss in total hip replacement, can seriously affect the recovery of postoperative joint function, but the specific influential factors and mechanisms remain unknown at present. OBJECTIVE:To evaluate the relative influential factors for hidden blood loss after primary total hip arthroplasty by the blood loss condition, and to analyze the association between hidden blood loss and prognosis. METHODS:Clinical data of 110 patients who underwent primary total hip arthroplasty in the Liuzhou Worker’s Hospital between April 2011 and April 2013 were retrospectively analyzed. The hidden blood loss was calculated according to Ward and Gross formula. The effects of patient’s gender, age, body mass index, type of prosthesis, presence of internal diseases, and different causes of a disease on hidden blood loss after arthroplasty were analyzed. The patients were divided into the high blood loss group (≥ 480 mL) and the low blood loss group (<480 mL) according to the hidden blood loss. Al the patients were fol owed up for 1 year. The Harris hip score system was used to assess the recovery of hip joint function between the two groups. The correlation between hidden blood loss and the recovery of joint function was analyzed using Pearson’s correlation analysis RESULTS AND CONCLUSION:The total blood loss of primary total hip arthroplasty was (1 340±367) mL, and the hidden blood loss was (748±324) mL, and the percentage of hidden blood loss was 53.7%. The type of prosthesis, presence of internal diseases, and different causes of a disease were significantly associated with hidden blood loss after total hip arthroplasty (P<0.05). Gender, age, body mass index, and operation time were not significantly associated with hidden blood loss after total hip arthroplasty (P>0.05). The hidden blood loss was correlated with postoperative functional recovery (P=0.046). Results indicated that type of prosthesis, presence of internal diseases, and different causes of a disease are main influential factors for hidden blood loss after total hip arthroplasty. The hidden blood loss has some influence on the recovery of postoperative joint function.
