隐性失血对全膝关节置换术后膝关节功能的影响

Correlation of Knee Joint Function and Hidden Blood Loss after Total Knee Arthroplasty

目的探讨隐性失血与全膝关节置换术后膝关节功能的相关性并进一步分析其影响因素。方法回顾性分析行单侧全膝关节置换术的84例患者的临床资料,计算其隐性失血量并采用美国膝关节协会(knee society score,KSS)功能评分随访术后3个月、6个月、1年的膝关节功能,分析两者之间的相关性;同时分析性别、年龄、体重指数、术中是否输血、使用假体类型以及术后抗凝方案等对术后隐性失血发生的影响。结果低隐性失血组在术后3个月、6个月及1年的KSS功能评分均高于高隐性失血组,差异有统计学意义(P<0.05)。单因素及多因素分析结果显示年龄、性别以及植入的假体类型与隐性失血发生密切相关(P<0.05)。结论隐性失血可影响全膝关节置换术后膝关节功能的恢复,且其与性别、年龄、假体类型有关,围手术期有针对性的预防有利于术后膝关节功能的恢复。

Objective To investigate the correlation and influence factors of knee joint function for hidden blood loss after total knee arthroplasty. Methods A retrospective study of 84 cases who underwent total knee arthroplasty was performed to calculate the hidden blood loss and evaluate the knee joint function score after 3 month, 6 month, 1 years of follow-up. The effect of patient gender, age, body mass index, ntraoperative blood transfusion, the use of prosthesis type, and postoperative anti- coagulation on the postoperative hidden blood loss were analyzed. Results The functional scores of KSS in the patients with low hidden blood loss were higher than those with high hidden blood loss at 3 month,6 month, 1 years of follow-up. The differ- ence was statistically significant （ P 〈 0.05 ）. Unvaried and multivariate linear regression ananlysis showed that postoperative hidden blood loss were associated with the patient gender, age and prosthesis type （ P 〈 0.05 ）. Conclusion Hidden blood loss can affect the recovery of knee joint function after total knee arthroplasty, and the gender, age, prosthesis type are its inde- pendent risk factors, early prevention in perioperative period is conducive to the recovery of knee joint function after surgery.