全膝关节置换术围手术期失血量的评估

Evaluation of perioperative blood loss following total knee arthroplasty

目的评估人工全膝关节置换术(TKA)围手术期的显性和隐性失血量。方法对2002～2005年的40例TKA患者进行回顾性分析,通过Gross方程推算患者术后平均显性失血量及隐性失血量。结果平均总失血量1538ml,其中显性失血量747ml(49%),隐性失血量是791ml(51%)。使用自体血回输患者的总失血量是1650ml,其中显性失血量903ml(52%),隐性失血量是786ml(48%);未使用自体血回输患者的总失血量是1370ml,其中显性失血量572ml(42%),隐性失血量是798ml(58%)。结论TKA隐性失血占总失血量的比例较高,使用自体血回输不能完全满足机体恢复体循环的需要,在围手术期要注意及时补充血容量。

Objective To evaluate perioperative occult blood loss following total knee arthroplasty （TKA）. Methods A retrospective analysis of 40 patients undergoing TKA was conducted to calculate the mean blood loss and occult blood loss according to Gross formula. Results The mean total blood loss was 1538 ml in these cases with occult blood loss of 791 ml. In patients with autologous blood transfusion, the mean total blood loss was 1650 ml with occult blood loss of 786 ml. In patients without autologous blood transfusion, the mean total blood loss was 1370 ml with occult loss of 798 ml. Conclusion TKA often results in large volume of occult blood loss in the perioperative period which can not be fully compensated by autologous blood transfusion, and additional blood supply is needed for maintenance of the circulating volume.