加温输血对关节置换术患者术后恢复质量的影响  

Effects of warming blood transfusion on the quality of post-operative recovery in patients undergoing arthroplasty

作　　者：俞一瑾[1] 魏昌伟[1] 陈易[1] 魏月霞[1] 倪新莉[2] 熊利泽[3] 

机构地区：[1]宁夏医科大学,银川市750004 [2]宁夏医科大学总医院麻醉科 [3]第四军医大学西京医院麻醉科

出　　处：《临床麻醉学杂志》2014年第1期17-20,共4页Journal of Clinical Anesthesiology

基　　金：宁夏回族自冶区科技攻关计划宁陕合作项目(2012)

摘　　要：目的 通过观察加温输血与否对髋膝关节置换术后患者各功能指标恢复差异的变化,探讨加温输血对术后恢复质量的影响.方法 选择全麻下择期行髋膝关节置换手术的成年患者150例,ASAⅠ或Ⅱ级,随机均分为加温输血组（加温组）和对照组.采用术后恢复质量评估表PQRS进行前瞻性评估.分别于术前（T0）、拔管后15 min（T1）、40 min（T2）、术后第1天（T3）、第3天（T4）、第7天（T5）评估患者生理功能、伤害性感受、情感变化、日常活动能力及认知功能,比较两组患者在术后不同时点整体恢复评分等级的差异以及各指标恢复率及发生率的差异.结果 两组在术后各时点总体恢复质量评分各等级分布差异无统计学意义.与对照组比较,加温组患者在T5时抑郁发生率较低（0％ vs 8％）（P＜0.05）.T3～T5时两组患者认知功能恢复率差异无统计学意义,T1～T5时两组生理功能恢复率、疼痛及恶心呕吐发生率差异无统计学意义.结论 髋膝关节置换术中少量加温输血对患者术后恢复质量无明显影响.Objective To investigate the effects of warming blood transfusion on postoperative recovery quality in patients undergoing knee or hip arthroplasty.Methods One hundred and fifty ASA Ⅰ or Ⅱ general aneasthesia patients undergoing selective knee or hip arthroplasty were prospectively and randomly divided into warming blood transfusion group and control group.Physiologic function,nonciception response,emotional state,activities of daily living and cognitive function were assessed by Post-operative Quality Recovery Scale before operation （T0）,15 min （T1） and 40 min （T2） after extubation,1st（T3）,3rd（T4） and 7th day（T5） after operation.Results There was no significant difference in general recovery quality and distribution between two groups.Compared with control group,group B had a lower incidence of depression at T5 （0% vs 8%）（P〈0.05）.There was no significant difference of cognitive function from T3 to T5 between two groups.There was no significant difference in physiologic function,postoperative pain,nausea and vomiting from T1 to T5 between two groups.Conclusion Warming blood transfusion has no effect on post-operative recovery quality in patients undergoing knee or hip arthroplasty.

关 键 词：加温输血 术后质量恢复量表 认知功能 

分 类 号：R687.3[医药卫生—骨科学]