术前血沉值对女性骨关节炎患者人工膝关节置换术围手术期输血的影响  

Preoperative erythrocyte sedimentation rate associates with perioperative blood transfusion in female osteoarthritis patients undergoing primary total knee arthroplasty

作　　者：张志奇[1] 刘进[1] 何爱珊[1] 黄广鑫[1] 康焱[1] 杨子波[1] 张紫机[1] 方淑莺[1] 傅明[1] 廖威明[1] 

机构地区：[1]中山大学附属第一医院关节外科,广州510080

出　　处：《中华关节外科杂志（电子版）》2013年第5期43-46,共4页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：国家自然科学基金(81171709;81201388)

摘　　要：目的研究女性骨关节炎患者行初次人工膝关节置换术中围手术期输血量和输血需求相关的临床因素。方法回顾性分析符合本组严格病例筛选标准的59例女性膝关节骨关节炎患者的病历资料,这些患者均为接受初次人工膝关节表面置换术(共71个膝关节)。评估患者年龄、高血压病史、手术麻醉方式、手术时间、假体厂家、术前血红蛋白值及血沉值等临床因素对围手术期出血量以及输血量的影响。结果术前血沉值异常患者较血沉值正常患者围手术期的输血量更大(Z=-2.015,P<0.05),血沉值对输血量的影响有统计学意义(P<0.05);血沉值与围手术期输血量呈正相关(r=0.347,P<0.01)。在年龄≥65岁患者中,术前血沉值异常患者围手术期输血量比血沉值正常患者明显增多(Z=-2.915,P<0.01),血沉值(P<0.01)与血红蛋白值(P<0.05)对输血量的影响有统计学意义;血沉值与输血量的正性相关有高度显著性(r=0.489,P<0.01)结论对于女性骨关节炎患者,术前血沉值可能是预测人工膝关节置换术围手术期输血量的指标之一。Objective To identify the relationship between preoperative factors and transfusion requirements of female osteoarthritis （OA） patients undergoing primary total knee arthroplasty （TKA）. Methods Age, surgical time, presence of hypertension, anesthesia, implants, preoperative hemoglobin （HB） value, and erythrocyte sedimentation rate （ESR） were analyzed in this retrospective study. 59 female OA patients （71 knees） , who met our inclusion criteria and underwent primary TKA, were included. Results The patients with ESR 〉 20 mm/h received more transfusion than those with normal level ESR （Z = -2. 015 ,P 〈 0. 05 ）. ESR showed significant association with transfusion （P 〈 0. 05 ）, and no other factor was relevant. When patients over 65 years old were separately analyzed, significantly more transfusions were applied during or after TKA in patients with ESR 〉20 mm/h （Z = -2. 915, P 〈0. 01 ） ; ESR （P 〈0. 01 ） and HB （P 〈 0. 05 ） showed significant association with transfusion. The preoperative ESR level was highly positively correlated with the perioperative transfusion （ r = 0. 347, P 〈 0. 01 ） , especially in the patients over 65 years old （ r = 0. 489,P 〈 0. 01 ）. Conclusion The findings indicate that in the female OA patients, the preoperative ESR is highly associated with blood transfusion and it could be a potentially reliable biomarker for perioperative allogenic blood transfusion.

关 键 词：血沉 关节成形术 置换 膝 输血 骨关节炎 女性 

分 类 号：R687.4[医药卫生—骨科学]