下肢继发性淋巴水肿患者脂肪抽吸术中失血的处理

The management of blood loss during liposuction for secondary lymphedema of lower extremities

目的分析下肢继发性淋巴水肿患者脂肪抽吸术的失血量情况,总结相关经验及处理策略。方法回顾性分析2018年9月至2020年1月共214例单侧下肢继发性淋巴水肿行脂肪抽吸术治疗患者的临床资料。结果患者中女209例,男5例,平均抽脂量(2934.58±1114.83 ml),平均失血量(986.04±425.16)ml,输血患者117例,其中输注自体血90例,输注异体血15例,输注自体血+异体血12例,患者淋巴水肿的分期、手术时间、抽脂量与失血量呈正相关,是影响术中失血量的独立危险因素。结论下肢继发性淋巴水肿患者脂肪抽吸术的抽脂量较大、失血量较多,是导致术后贫血的重要因素。

Objective To handle blood loss during liposuction for secondary lymphedema of lower extremities in patients with secondary lymphedema.Methods The clinical data of 214 patients with secondary lymphedema of the lower extremities undergoing liposuction at Department of Lymphatic Surgery,Capital Medical University Affliated Beijing Shijitan Hospital from Sep 2018 to Jan 2020 were retrospectively analyzed.Results There were 209 females and 5 males.The average fat aspiration was(2934.58±1114.83)ml,the average blood loss was(986.04±425.16)ml,117 patients were transfused,including autologous transfusion in 90 patients,15 patients received allogeneic blood,and 12 patients received autologous plus allogeneic blood.The disease phase,operative time and fat aspiration were positively correlated with blood loss,and were independent risk factors affecting blood loss.Conclusion Liposuction for secondary lymphedema of the lower extremity is an important factor leading to anemia.