血红蛋白<80g/L作为儿童发育性髋关节发育不良术后输血指征安全性的初步观察  

Is it safe to consider hemoglobin < 80 g /L as transfusion indication after operation of developmental dysplasia of the hip in children-a preliminary report

作　　者：李天友[1] 王延宙[1] 王恒冰[1] 张敏刚[1] 王继孟[1] 

机构地区：[1]山东大学附属省立医院小儿骨科,济南250021

出　　处：《中国矫形外科杂志》2014年第13期1182-1185,共4页Orthopedic Journal of China

基　　金：山东省医药卫生科技发展计划项目(编号:2011QW018)

摘　　要：[目的]初步观察以血红蛋白（hemoglobin，Hb）〈80g／L作为发育性髋关节发育不良（developmental dysplasia of the hip，DDH）行髋关节切开复位联合Pemberton骨盆截骨以及股骨短缩旋转截骨术后输血指征的安全性。[方法]对在本院行切开复位联合Pemberton骨盆截骨、股骨短缩旋转截骨术的DDH患儿进行前瞻性研究，所有患儿术前及术后第1、4d，6周行血常规检查测定Hb，配对t检验比较各时间点之间Hb的差别。以Hb〈80g／L为输注红细胞的指征，统计输血患儿比例，分析影响输血的相关因素。[结果]2010年11月～2011年8月共有52例DDH患儿行切开复位联合Pemberton骨盆截骨、股骨短缩旋转截骨术，其中男5例，女47例，平均年龄（2．43±1．37）岁。术前Hb平均为（124．35±11．13）g／L；术后第1d平均为（101．57±10．71）g／L，较术前低（22．77±10．47）g／L（P=0．00）；术后第4d降至（93．98±8．74）g／L，较术后第1d低（9．02±6．20）g/L（P=0．00）；术后6周回升至（118．88±9．39）g／L，较术后第1d高（17．31±9．90）g／L（P=0．00）。本组患儿均未发生失血性休克，共4例（7．69％）输血，Logistic多因素回归分析显示是否需要输血与性别、年龄、体重、侧别、脱位程度以及手术时间之间的相关性均无统计学意义。[结论]以Hb〈80g／L作为DDH切开复位联合Pemberton骨盆截骨、股骨短缩旋转截骨术后输血指征安全可行。[ Objective] To determine whether it is safe to consider hemoglobin （Hb） 〈 80 g/L as transfusion indication after open reduction and Pemberton pelvic osteotomy and femoral shortening rotational osteotomy in developmental dysplasia of the hip （DDH） . [ Methods] Prospective study was performed to DDH who was given open reduction and Pemberton pelvic osteot- omy and femoral shortening rotational osteotomy in our hospital. All patients were given blood routine examination to measure Hb before operation and at 1 day, 4 days, 6 weeks after operation. The Hb was compared between different time points. Hb 〈 80 g/ L was considered as transfusion indication. The number of patients needing transfusion was recorded, and the transfusion - related factors were analyzed. [ Results] A total of 52 children with DDH were performed open reduction and Pemberton pelvic osteotomy and femoral shortening rotational osteotomy from November 2010 to August 2011, including 5 males and 47 females, with the mean age of （2.43 ± 1.37） years old. The mean Hb was （ 124. 35 ± 11.13 ） g/L before operation. It was （ 101.57 ± 10. 71 ） g/ L one day after operation, （22. 77 ± 10. 47） g/L lower than preoperative （ P = 0. 00） . And it dropped to （93.98 ± 8.74） g/L 4 days after operation, （9. 02±6. 20） g/L lower compared with 1 day after operation （P =0. 00） . The mean Hb was rebounded to （ 118. 88 ± 9. 39） g/L 6 weeks after surgery, （ 17. 31 ± 9. 90） g/L higher than 1 day after operation （P = 0. 00） . No hemorrhagic shock was found in all patients, and 4 （7. 69% ） cases received Hb transfusion. Logistic regression analysis showed no statistical significance of the correlation between Hb transfusion and gender, age, weight, side, grade, operation time. [ Conclusion] It is safe to consider Hb 〈 80 g/L as transfusion indication after open reduction and Pemberton pelvic osteotomy and femoral shortening rotational osteotomy in DDH.

关 键 词：髋脱位 先天性 输血 截骨术 血红蛋白测定 

分 类 号：R726.8[医药卫生—儿科]