CAJ | 학술논문

背景：总失血量、隐性失血量是否与病因相关，在不同病因下行全髋关节置换的患者其总失血量、隐性失血量是否不同，以及是否应针对某一特定病因行术前干预，仍缺乏相关的临床研究。目的：对比分析髋关节骨性关节炎和股骨颈骨折患者全髋关节置换后隐性失血量。方法：收集分析2013年6月至2015年1月行单侧全髋关节置换治疗的150例患者的临床资料，其中髋关节骨性关节炎患者54例(男30例，女24例)，股骨颈骨折患者96例(男41例，女55例)。对患者置换前、置换后血常规及置换过程中、置换后出血、输血情况进行记录，并对患者围置换期隐性失血情况进行评估。结果与结论：全部患者总失血量为(1616±216) mL，隐性失血量为(699±102) mL，隐性失血量占总失血量的43.3%。髋关节骨性关节炎组总失血量为(1742±254) mL，隐性失血量为(758±127) mL，隐性失血量占总失血量的44.6%；股骨颈骨折组平均总失血量为(1470±189) mL，隐性失血量为(625±98) mL，隐性失血量占总失血量的42.1%。髋关节骨性关节炎组的总失血量及隐性失血量均显著高于股骨颈骨折组(P <0.05)，但两组之间隐性失血量占总失血量的比例差异无显著性意义(P=0.4193)。提示在两种病因前提下行全髋关节置换的患者，其总失血量及隐性失血量是不同的。因此在全髋关节置换前应充分考虑到患者的原发病因，预估总失血量及隐性失血量，及时采取相应的预防处理措施，确保置换过程的安全性。
배경：총실혈량、은성실혈량시부여병인상관，재불동병인하행전관관절치환적환자기총실혈량、은성실혈량시부불동，이급시부응침대모일특정병인행술전간예，잉결핍상관적림상연구。목적：대비분석관관절골성관절염화고골경골절환자전관관절치환후은성실혈량。방법：수집분석2013년6월지2015년1월행단측전관관절치환치료적150례환자적림상자료，기중관관절골성관절염환자54례(남30례，녀24례)，고골경골절환자96례(남41례，녀55례)。대환자치환전、치환후혈상규급치환과정중、치환후출혈、수혈정황진행기록，병대환자위치환기은성실혈정황진행평고。결과여결론：전부환자총실혈량위(1616±216) mL，은성실혈량위(699±102) mL，은성실혈량점총실혈량적43.3%。관관절골성관절염조총실혈량위(1742±254) mL，은성실혈량위(758±127) mL，은성실혈량점총실혈량적44.6%；고골경골절조평균총실혈량위(1470±189) mL，은성실혈량위(625±98) mL，은성실혈량점총실혈량적42.1%。관관절골성관절염조적총실혈량급은성실혈량균현저고우고골경골절조(P <0.05)，단량조지간은성실혈량점총실혈량적비례차이무현저성의의(P=0.4193)。제시재량충병인전제하행전관관절치환적환자，기총실혈량급은성실혈량시불동적。인차재전관관절치환전응충분고필도환자적원발병인，예고총실혈량급은성실혈량，급시채취상응적예방처리조시，학보치환과정적안전성。
BACKGROUND:There were stil lacking related clinical researches in the aspects of whether the total blood loss and hidden blood loss were connected with pathogenesis, whether the total blood loss and hidden blood loss were different among the patients who conducted total hip arthroplasty under different pathogenesis, and whether the preoperative intervention should be conducted for a particular cause? OBJECTIVE:To compare and analyze the hidden blood loss of patients with hip osteoarthritis and femoral neck fracture after total hip replacement. METHODS:The clinical data of 150 patients who received the unilateral total hip arthroplasty treatment from June 2013 to January 2015 were colected and analyzed, including 54 patients with hip osteoarthritis (30 male cases and 24 female cases ), 96 patients with femoral neck fracture (41 male cases and 55 female cases). The pre-and post-operative blood routine and intro-and post-operative blood loss and transfusion were recorded, and hidden blood loss during pen-operation period was evaluated. RESULTS AND CONCLUSION:Total blood loss was (1 616±216) mL, hidden blood loss was (699±102) mL, and hidden blood loss accounted for 43.3% of the total blood loss. The total blood loss was (1 742±254) mL in the hip osteoarthritis group, hidden blood loss was (758±127) mL, hidden blood loss accounted for 44.6% of the total blood loss; The average total blood loss was (1 470±189) mL in the femoral neck fracture group, hidden blood loss was (625±98) mL, hidden blood loss accounts for 42.1% of the total blood loss. The total blood loss and hidden blood loss in hip osteoarthritis group were significantly higher than those in the femoral neck fracture group (P< 0.05). However, there was no significant difference on the hidden blood loss accounts for the proportion of the total blood loss between two groups (P=0.419 3). These results suggest that the total blood loss and hidden blood loss are different for the patients who underwent total hip arthroplasty in the premise of both pathogenesis. Therefore, before the total hip arthroplasty, we should fuly take into account the primary cause of patients and estimate the total blood loss and hidden blood loss, so as to take appropriate preventive measures in time to ensure the safety of the replacement process.