CAJ | 학술논문

目的研究不同方式人工髋关节置换术围手术期失血量的差异。方法2008年1月至2010年12月，行髋关节置换术42例，其中男25例，女17例；年龄27岁-82岁，平均65.3岁。所有病例均为初次置换。髋关节置换方式包括骨水泥型人工股骨头置换、生物型人工股骨头置换、骨水泥型全髋关节置换、生物型全髋关节置换。通过Gross方程，根据身高、体重和手术前后的红细胞压积计算所有患者的总失血量，减去显性失血部分后为隐性失血量。结果人工股骨头置换两组间、全髋关节置换两组间在身高、体重、年龄及显性失血、隐性失血、术后失血、总失血量方面分别比较均无显著性差异；人工股骨头置换组和全髋关节置换组在身高、体重及隐性失血、术后失血、总失血量方面分别比较均无显著性差异；但两组患者年龄相比较有显著性差异（P<0.05）；两组患者显性失血量间相比较有显著性差异（P=0.00）。结论不同方式的髋关节置换术在总失血量、显性失血量、隐性失血量无统计学差异，但均存在明显的隐性失血。因此髋关节置换术后3日内需密切监测血红蛋白的动态变化和临床表现，及时补充异体血。
목적연구불동방식인공관관절치환술위수술기실혈량적차이。방법2008년1월지2010년12월，행관관절치환술42례，기중남25례，녀17례；년령27세-82세，평균65.3세。소유병례균위초차치환。관관절치환방식포괄골수니형인공고골두치환、생물형인공고골두치환、골수니형전관관절치환、생물형전관관절치환。통과Gross방정，근거신고、체중화수술전후적홍세포압적계산소유환자적총실혈량，감거현성실혈부분후위은성실혈량。결과인공고골두치환량조간、전관관절치환량조간재신고、체중、년령급현성실혈、은성실혈、술후실혈、총실혈량방면분별비교균무현저성차이；인공고골두치환조화전관관절치환조재신고、체중급은성실혈、술후실혈、총실혈량방면분별비교균무현저성차이；단량조환자년령상비교유현저성차이（P<0.05）；량조환자현성실혈량간상비교유현저성차이（P=0.00）。결론불동방식적관관절치환술재총실혈량、현성실혈량、은성실혈량무통계학차이，단균존재명현적은성실혈。인차관관절치환술후3일내수밀절감측혈홍단백적동태변화화림상표현，급시보충이체혈。
Objective Different ways total hip replacement in the Peri-operative blood loss differences Methods January 2008 to December 2010, 42 cases of hip joint replacement surgery, including 25 males and 17 females; aged 27 -82 years, mean 65.3 years. All the cases were the initial replacement. Hip replacement, including cemented hemiarthroplasty biological hemiarthroplasty, cemented total hip replacement, biotype total hip arthroplasty.Gross equation, according to height, weight, and preoperative and postoperative red blood cell hematocrit calculation of the total blood loss for all patients, less dominant bleeding part of the hidden blood loss Results Between the two groups of hemiarthroplasty or total hip arthroplasty between the two groups in height, weight, age and dominant blood loss, hidden blood loss, postoperative blood loss, total blood loss showed no significant difference; hemiarthroplastygroup and total hip joint replacement in height, weight and hidden blood loss, postoperative blood loss, total blood loss showed no significant difference; but the two groups were age compared to the significant difference (P <0.05); twodominant blood loss in patients compared with a significant difference (P = 0.00). Condusion Different ways of hip arthroplasty was no significant difference in total blood loss, the dominant blood loss, hidden blood loss, but there are significant hidden blood loss. After total hip arthroplasty to the dynamic changes and clinical manifestations of the 3 days of close monitoring of hemoglobin and to replenish the allogeneic blood.