人工全髋关节置换术隐性失血量的估算及原因分析

Calculation and cause analysis of hidden blood loss in total hip arthroplasty

目的探讨人工全髋关节置换术(total hip and total knee arthroplasty,THA)隐性失血的发生机制及其危险因素作用关系。方法从笔者所在医院2008-03～2010-01收治患者中抽取80例单侧THA,通过Gross方程计算出隐性失血量。记录不同年龄(≤70周岁),有无内科疾病(高血压病、糖尿病、冠心病),性别,不同疾病之间,肥胖(>BMI30 kg/m2)等情况下THA围手术期隐性失血量,分析讨论围手术期隐性失血的发生机制和危险因素。结果围手术期的实际失血总量平均为1320 ml,隐性失血为436 ml,占33%。年龄、有无内科疾病、性别在隐性失血的量方面有统计学差异,而不同疾病之间、肥胖则在隐性失血的量方面无统计学差异。结论高龄患者、有内科疾病症者、男性等情况下隐性失血增多,对这些情况围手术期更应提高认识,及时补充异体血。

Objective To explore the incidence mechanism, risk factors and volume calculation of hidden blood loss in THA （total hip arthroplasty）. Method The 80 cases of unilateral THA treated in author＇s hospital from March 2008 to January 2010 were involved in this study. The volume of hidde blood loss was calculated by the Gross equation. Perioperative hidden blood loss was studied according to ages, preexisting diseases（hypertension, diabetes and coronary heart disease）, gender, tourniquet time, different diseases and obesity. And the incidence mechanism of hidden blood loss and its risk factors were explored. Results The mean total perioperative blood loss was 1320 ml. Hidden blood loss was 436 ml, accounting for 33%. The hidden blood loss had statistically significant difference at different ages, preexisting diseases and gender, while the difference did not have statistical significance at different diseases and obesity. Conclusion More hidden blood loss is found in elderly patients, patients with existing diseases and male patients. In above cases allogeneic blood transfusion should be timely taken.