关节置换术中围手术期失血量的计算方法

Perioperative calculation method of blood loss volume in joint replacement

目前，人工关节置换是关节疾病患者减轻疼痛和提高生活质量的一种有效治疗手段。2006年美国髋、膝关节置换总量约800000例，英国约130000例[1]。进行关节置换术的患者常发生血液大量丢失的情况。在初次全髋关节置换术（ total hip arthroplasty，THA ）失血量（ allowable blood loss ）的范围是726～1768 ml[2-6]，而在初次全膝关节置换术（ total knee arthroplasty，TKA ）失血量的范围是1188～1651 ml[7-10]。但是，准确的失血量很难估算。原因是计算失血量方法不同，缺乏可比性。因此，用一个公认的计算公式，来估算围术期的失血量显得至关重要。为此，对关节置换术围手术期失血量的不同计算方法介绍如下。

As the population ages, the number of joint replacement is increasing every year. It can relieve joint pain in elderly patients or resume normal walking ability. However, joint replacement causes massive blood loss in patients, increasing mortality. Higher volume of blood loss will occur when patients are in long-term chronic diseases or prosthesis revision surgery. Today, there are many types of formulas to estimate perioperative blood loss volume during joint replacement. However, it has failed to reach a consensus in the calculation method. Therefore, a good formula to calculate the volume of blood loss is necessary. This paper describes a variety of formulas, allowing orthopedic surgeons to choose a more accurate and practical one for calculation. It would provide help for future clinical studies.