减少人工全膝关节置换术围手术期失血措施的研究进展

Research progress in reducing perioperative blood loss in total knee arthroplasty

随着我国人口老龄化,人工全膝关节置换术(total knee arthroplasty,TKA)手术量逐年增加。TKA术中的松质骨截骨和软组织松解会导致患者血液丢失,甚至造成术后贫血,给患者造成头晕等不适症状,且影响患者及患肢功能的快速康复,常需行同种异体输血治疗。而输血又存在传播疾病等风险,因此,减少TKA围手术期的失血就显得至关重要。目前,减少TKA围手术期失血的常用措施包括术前贫血的治疗、术中氨甲环酸的使用、术后引流管的使用等。

The rapid increase in the aging population in China results in a growing number of total knee arthroplasty(TKA)year by year.The cancellous bone osteotomy and soft tissue loosening in TKA can lead to blood loss or even postoperative anemia,often requiring allogeneic blood transfusion.Anemia can cause dizziness and other uncomfortable symptoms,hindering the rapid recovery of the patients and the restoration of the limb functions,while allogeneic blood transfusion has the risk of spreading disease.Therefore,reducing blood loss in TKA perioperatively is of great importance.At present,the common approaches include the treatment of preoperative anemia,administration of tranexamic acid in the operation,and postoperative drainage of the wound,etc.