基于快速康复外科理念的血液保护管理对全髋关节置换术患者的影响

Effect of blood protection management based on the concept of fast track surgery in patients undergoing total hip arthroplasty

目的探讨基于快速康复外科理念(FTS)的血液保护管理对全髋关节置换术患者的影响。方法选取2016年3月至2019年4月于本院就诊行全髋关节置换术治疗的68例患者作为研究对象,按照随机对照的原则,将其等分为观察组与对照组,对照组采用常规血液管理,观察组采用基于FTS的血液保护管理,比较两组术后3 d血红蛋白水平、凝血酶原时间,术中出血量与手术7 d内输红细胞量、输血率。结果术后3 d,观察组血红蛋白水平高于对照组(P <0. 05);两组凝血酶原时间比较差异无统计学意义(P> 0. 05)。观察组术中出血量、手术7 d内输红细胞量均低于对照组(P <0. 05);观察组无输血浆,对照组输血浆量(430. 75±89. 37) ml。结论基于FTS的血液保护管理用于全髋关节置换术能够有效降低贫血风险,避免术中失血及输血量增加,有利于患者早期快速康复,值得临床推广。

Objective To investigate the effect of blood protection management based on the concept of fast track surgery( FTS) in patients undergoing total hip arthroplasty. Methods To select 68 cases of patients who underwent total hip arthroplasty in our hospital from March 2016 to April 2019 as a study object. According to the principle of randomized control,they were divided into observation group and control group. The routine blood management was adopted in the control group,the observation group used the blood protection management based on the concept of FTS. The hemoglobin level,prothrombin time on the third day after operation,intraoperative blood loss and red blood cell volume and blood transfusion rate within 7 days after operation,which were compared between the two group. Results The hemoglobin level of the observation group was higher than that of the control group on the third day after operation( P < 0. 05). There was no significant difference in prothrombin time between the two group( P > 0. 05). The intraoperative blood loss and red blood cell volume within 7 days after operation in the observation group were significantly lower than those in the control group( P < 0. 05). The observation group didn’t implement plasma transfusion,but the control group received( 430. 75 ± 89. 37) ml of plasma transfusion. Conclusion The application of blood protection management based on the concept of FTS for total hip arthroplasty could effectively reduce the risk of anemia,avoid intraoperative blood loss and increased blood transfusion,and help patients to recover quickly,which was worthy of clinical promotion.