自体血回输在单侧人工全膝关节表面置换术后的临床观察  

Clinical study of autologous blood transfusion after unilateral total knee resurfacing arthroplasty

作　　者：于一萍[1] 刘素霞[1] 刘淑芳[1] 钱东阳[1] 

机构地区：[1]广州医学院第一附属医院骨科,510120

出　　处：《中华关节外科杂志（电子版）》2011年第2期28-30,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨人工全膝关节表面置换术后自体血回输的安全性、有效性及护理特点。方法使用回顾性质量评估设计,比较了2005～2009年本组行单侧人工全膝关节表面置换术患者120例,其中60例采用自体血回输装置(A组),60例术后伤口采用常规引流袋引流(B组)。根据患者的临床表现和血红蛋白水平决定异体血的输入量,使术后血红蛋白水平维持在10g/dL以上。比较两组患者术后8h内及术后总引流量;比较两组患者术前、术后第1天、术后第7天的血红蛋白变化及术后平均输血量、输异体血比例。观察两组患者输血后不良反应的发生情况。结果两组患者8h内引流量以及术后总引流量比较,差异均无统计学意义(P>0.05)。两组患者术前、术后第7天血红蛋白的变化无统计学差异(P>0.05),术后第1天血红蛋白的变化有统计学意义(P<0.05)。A组术后自体血回输量平均为382.5ml,术后有9例接受异体血输血,平均异体血输入量134.3ml;A组所有自体血回输未出现输血反应,无感染等并发症。B组术后23例接受异体血输血,平均异体血输入量252.4ml;B组异体血输血过程中有3例出现发热反应。输异体血的比例为A组15.0%,B组38.3%。结论单侧人工全膝关节表面置换术后使用自体血回输是安全有效的,能够节约血源,避免血液传播疾病的发生,临床效果好,值得推广应用。Objective To discuss the safety, effectiveness, and the nursing characteristics of autologous blood transfusion after total knee arthroplasty. Methods 120 cases of total knee arthroplasties which were carried out in our hospital from 2005 to 2009, were retrospectively compared by quality assessment. 60 cases in group A used autotransfusion drains, while the other 60 cases in group B used conventional drains. According to the level of hemoglobin, the volumes of allogenic blood transfusion were adjusted to maintain the Hb above 10 g/dL post-operatively. Data of two groups were compared, including the postoperative drainage volume within 8 hours, the total drainage volume, the Hb level （before operation, the first day and the seventh day after operation ）, the average transfusion volume and the proportion of allogenic blood transfusion after surgery. The adverse reactions were also observed. Results There was no significant differences （ P 〉 0.05 ） between two groups in the total drainage volume and the postoperative drainage volume within 8 hours. There was no statistical difference in Hb level （ P 〉 0. 05 ） before operation and seven days after operation, yet there was significant difference in the Hb level （ P 〈 0. 05 ） on the first day after operation. The average volume of autologous blood transfusion was 382.5 ml in group A, and the average volume of it was 134.3 ml. There was no transfusion reaction nor infection in group A. 23 cases accepted allogenic blood transfusion in group B with an average volume of 252.4 ml, among which three cases had a febrile reaction. The proportion of allogenic blood transfusion was 15.0% in group A and 38.3% in group B. Conclusions The autologous blood transfusion is safe and effective after unilateral total knee arthroplasty, which can save blood sources, and avoid blood transmitted diseases. It isworthy of application.

关 键 词：回输血 自体血 关节成形术 置换 膝 

分 类 号：R687.4[医药卫生—骨科学]