初次单侧单髁置换术后隐性失血危险因素的分析

Analysis of risk factors associated with hemorrhage after unilateral unicompartmental knee arthroplasty

目的探讨影响单髁置换术后隐性失血的危险因素。方法对2015年1月至2016年12月在我科行初次膝关节内侧髁置换术的273例患者行回顾性研究,其中男79例,女194例,年龄46~87岁,平均(67.21±8.23)岁。收集患者临床资料,根据Nadler公式计算血容量,再结合Gross方程计算术后3 d的隐性失血量;对相关危险因素进行统计学分析。结果隐性失血量为(75.36±10.21)m L,术后总失血量为(187.35±60.31)m L。性别、体质指数(BMI)及假体类型为单髁置换术后隐性失血的危险因素。结论单髁置换术后的隐性失血量与性别、BMI及假体类型相关;对于男性及肥胖患者应积极采取全程出血管理,更合理地选择假体类型。

Objective To explore the risk factors of hidden blood loss after UKA. Methods A retrospec-tive study was conducted on 273 patients who underwent UKA from January 2015 to December 2016,including79 males and 194 females,age between 46 to 87 years old,mean age（67.21± 8.23）years old. The clinical datawere collected and the blood volume was calculated according to the Nadler formula. The Gross equation was usedto calculate the blood loss and the amount of occult blood loss at 3 days after operation. The risk factors wereanalyzed statistically. Results The volume of hidden blood loss after operation was（75.36 ± 10.21）mL,and thevolume of total blood lost after operation was（187.35± 60.31）mL. Sex,BMI and type of prosthesis were risk factorsfor hidden blood loss after UKA. Conclusions The volume of hidden blood loss after UKA was related to sex,BMI,and type of prosthesis. For the obese and male patients,we should actively take bleeding management andchoose the type of prosthesis reasonably.