人工全髋关节置换术病人围手术期的隐性失血分析

HIDDEN BLOOD LOSS IN PERI-OPERATION OF TOTAL HIP ARTHROPLASTY:AN ANALYSIS

目的通过手术前后血细胞比容（HCT）和血红蛋白（Hb）变化分析人工全髋关节置换术（THA）病人围手术期隐性失血情况。方法对47例THA病人临床资料进行回顾性分析,记录病人身高、体质量、术中及术后出血量、接受输血量、术前及术后HCT和Hb值,应用GROSS方程计算红细胞的容量,推算围手术期隐性失血量。结果 47例病人平均身高1.63m;平均体质量62.12kg;显性失血量200~600mL,平均400mL;男女两组病人术后HCT及Hb值较术前均有较大幅度下降,差异有统计学意义（t=18.01~92.14,P〈0.01）;THA围手术期隐性失血量平均（550.00±10.32）mL,男女两组间比较差异无统计学意义（P〉0.05）。结论围手术期THA隐性失血量较大,老年病人术后应重视隐性失血的处理。

Objective To analyze perioperative hidden blood loss in patients undergoing total hip anthroplasty（THA）through the changes of hematocrit（HCT）rate and hemoglobin（Hb）value-before and after surgery. Methods A retrospective analysis of clinical data of 47 patients undergoing THA was made.The height,weight,blood loss at surgery and after surgery,peri-and post-operative blood loss,the amount of blood transfusion,and pre-and post-operative rates of HCT and Hb were recorded.Employing GROSS formula,the capacity of red blood cells（RBC）was calculated and the peri-operative HBL reckoned. Results In the 47 patients,their average height was 1.63 mand average weight was 62.12 kg.Dominant blood loss was 200-600 mL,with an average of 400 mL.The postoperative values of HCT and Hb,in both male and female groups,showed large decline after surgery versus before,the difference was statistically significant（t=18.01-92.14,P〈0.01）.The average peri-operative hidden blood loss was（550.00±10.32）mL,the difference between male and female groups was not significant. Conclusion Peri-operative hidden blood loss in total hip arthroplasty is large,attention should be paid to this situation for senile patients after surgery.