血友病性与骨性关节炎全膝置换术后失血量的比较

Comparison of blood loss after total knee replacement for haemophilic and osteoarthritic arthritis

目的比较晚期血友病性关节炎(HA)与膝关节骨性关节炎(KOA)一期单侧全膝关节置换术后总出血量、显性失血量、隐性失血量等,评估HA的手术出血风险。方法回顾性分析2020年1月至2021年3月浙江中医药大学附属第一医院骨伤科收治的初次行单侧全膝关节置换术(TKA)的27例HA患者(HA组)和57例KOA患者(KOA组)的病例资料,对比分析两组TKA术后显性、隐性及总失血量、血红蛋白最大丢失量、输血率、术后住院时间。结果HA组总失血量、隐性失血量、血红蛋白最大丢失量、输血率、术后住院时间均明显高于KOA组,差异有统计学意义(P<0.05);两组住院期间均未出现血肿、感染、下肢深静脉血栓形成及关节假体松动等并发症。结论HA患者的术后失血量更多,在手术后应持续监测患者的血常规及凝血功能。

Objective To compare the total blood loss,dominant blood loss,hidden blood loss and other parts after one-stage unilateral total knee arthroplasty between advanced hemophilic arthritis(HA)and knee osteoarthritis(KOA),and assess the risk of bleeding during HA operation.Methods The case data of 27 HA patients(the HA group)and 57 KOA patients(the KOA group)with primary unilateral total knee arthroplasty(TKA)admitted to the Orthopedics Center of the First Affiliated Hospital of Zhejiang Chinese Medical University from January 2020 to March 2021 were retrospectively analyzed.The dominant,hidden and total blood loss,the maximum loss of hemoglobin,blood transfusion rate and postoperative hospital stay of patients after TKA were compared and analyzed in the two groups.Results The total blood loss,dominant blood loss,hidden blood loss,maximum hemoglobin loss,blood transfusion rate and postoperative hospital stay in the HA group were significantly higher than those in the KOA group,and the differences were statistically significant(P<0.05).There were no complications such as hematoma,infection,deep vein thrombosis of the lower extremities and loosening of the joint prosthesis during the hospitalization of the two groups.Conclusion HA patients have more blood loss after surgery.The blood routine and coagulation function of the patients should be continuously monitored after the operation.