髋关节翻修术中多模式血液管理的临床应用研究

Clinical application of multimodal blood management in hip revision surgery

目的研究在髋关节翻修术中应用中多模式血液管理的有效性和安全性。方法回顾性分析2015年1月—2017年7月安徽医科大学附属省立医院收治的27例全身麻醉下行首次人工髋关节翻修术患者,分为采用多模式血液管理的患者13例(实验组)和未采用多模式血液管理的患者14例(对照组)。分析两组术前一般资料差异,比较两组术前血红蛋白、手术时间、术中失血量、术后2 d血红蛋白、围手术期输血量、术后引流量、深静脉血栓形成、肺栓塞及其他术后并发症发生率。结果两组年龄、性别及体重指数等一般资料比较,差异无统计学意义(P>0.05);两组术前血红蛋白水平、手术时间及并发症发生率比较,差异无统计学意义(P>0.05);两组术中失血量、术后引流量、术后2 d血红蛋白及术后输血量比较,差异有统计学意义(P <0.05)。结论多模式血液管理可有效减少髋关节翻修术的术中出血量、术后引流量及术后输血量,在安全性方面未见不良反应。

Objective To study the efficacy and safety of multi-mode blood management in the primary revision hip arthroplasty.Methods Totally 27 patients underwent revision hip arthroplasty under general anesthesia from January 2015 to July 2017.13 patients with multi-mode blood management were enrolled in the experimental group,and the other 14 patients without multi-mode blood management were enrolled in the control group.The differences of age,sex and body mass index were compared between the experimental group and the control group.The preoperative hemoglobin,operation time,intraoperative blood loss,hemoglobin 2 days after operation,perioperative blood transfusion,postoperative drainage volume and the incidence of deep venous thrombosis,pulmonary embolism and other postoperative complications were compared between the two groups.Results There was no significant difference in age,sex and body mass index between the experimental group and the control group(P >0.05).There was no significant difference in preoperative hemoglobin,operative time or incidence of complications between the experimental group and the control group(P >0.05).There were significant differences in intraoperative blood loss,postoperative drainage volume,hemoglobin 2 days after operation and postoperative blood transfusion between the experimental group and control group(P<0.05).Conclusions Multimodal blood management can effectively reduce intraoperative blood loss,postoperative drainage,postoperative blood transfusion,and has no side effect in safety.