全髋关节置换术中输血的关联因素分析

Relatedfactors of blood transfusion during total hip arthroplasty

目的确定全髋关节置换手术中异体输血(ALBT)的关联因素。方法收集了258例本院全髋关节置换的患者。从电子病历系统和检验系统收集患者的基本信息手术信息及实验室数据。通过单因素和多因素逻辑回归分析得到输血的关联因素。结果异体血输血率为19%。影响患者ALBT的重要因素中性别、年龄、术中出血量、引流量、手术时间、术前血红蛋白(Hb)、术前活化部分凝血活酶时间(APTT)、术前凝血酶原时间(PT)、高血压这9项指标2组间的差异有统计学意义(P<0.05)。通过多因素回归分析其中对ALBT有意义的独立关联因素是年龄≥60岁(OR3.577)、术中出血量(OR1.003)、引流量(OR1.004)、和术前PT(OR1.888),术前Hb(OR0.94)是个保护性因素。结论通过分析相关的因素,可为患者提供具体的,个体化的异体输血的评估,减少输血。

Objective To investigate the related factors of allogeneic blood transfusion(ALBT) in total hip arthroplasty. Methods Thebasic information, surgical details and laboratory data of 258 patients who underwent total hip arthroplasty in Orthopedics Department of our hospital were collectedfrom the electronic medical record system and laboratorytest system. The factors concerningALBT were obtainedby single factor and multivariate logistic regression analysis. Results The ALBT rate in this study was 19%, and the differencesin such important factors affecting ALBT as gender, age, intraoperative blood loss, drainage volume, operation duration, preoperative hemoglobin(Hb), preoperative activated partial thromboplastin time(APTT), preoperative prothrombin time(PT) andhypertension between the two groupswere notable(P<0.05). Multivariate regression analysisrevealed that the independent related factors ofALBT were age ≥ 60 years(OR3.577), intraoperative blood loss(OR1.003), drainage volume(OR1.004)and preoperative PT(OR1.888). Preoperative Hb(OR0.94) was a protective factor.Conclusion Specific and individualized evaluation of ALBT, aimed atreducingunnecessary blood transfusion, can be provided through the analysis of relevant factors.