全膝关节置换术后隐性失血的临床研究  

The Clinical Study of Hidden Hemorrhage After Hip and Knee Arthroplast

作　　者：李小鑫[1] 吕福润[1] 

机构地区：[1]鄂尔多斯市中心医院骨科一区,内蒙古东胜017000

出　　处：《内蒙古医学杂志》2015年第4期406-408,共3页Inner Mongolia Medical Journal

摘　　要：目的讨论全膝关节置换术后隐性失血的相关机制以及临床影响。方法2006年7月至2011年12月人工全膝关节置换术146例，其中男46例，女100例，年龄60～75岁，平均年龄在71岁。所有病例都为初次行单侧关节置换的患者，其中在24h里，补液总量均不超过2000ml，通过Gross方程并结合患者身高，体重和手术前后的红细胞压积计算所有患者的总失血量，然后减掉显性失血部分就能够得到隐性失血。结果在这些病例中使用引流血回输患者的总失血量平均是1250。隐性失血量达到了600ml，比例达到了48％，未经引流血回输患者的总失血量平均则为1120ml，经过对显性失血量的消除得出隐性失血量为650ml，两者比例达到了58％。结论全膝关节置换术后隐性失血量比较高，几乎达到了显性失血的一半，引流血回输并不能够满足机体恢复循环的需要，因此需要及时补充血容量，对隐性失血的正确分析有助于提升临床的评估能力，帮助全膝关节置换术患者能够顺利度过手术期。Objective The purpose of this paper to discuss after total knee arthroplasty hidden hemorrhage related mechanism and clinical effects. Methods 2006 July to 2011 December artificial total knee arthroplasty in 146 cases, among male patients in 46 Cases, 100 cases of female patients, aged 60 to 75 years old between pa- tients, mean age at 71 years old. In all cases for the first time in patients with unilateral hip arthroplasty, which in 24 h, rehydration aggregates are not more than 2 000 ml, through the Gross equation and the combination in patients with height, weight and operation and the hematocrit was calculated for all patients of total blood loss, then lose part of dominant blood loss can be hidden blood loss. Results In these cases the use of drainage blood transfusion in patients with total blood loss was 1250, occult blood loss at 600 ml, the ratio reached 48 %, with- out drainage of blood exchange transfusion in patients with total blood loss is 1120ml, the dominant blood loss e- limination that hidden blood loss was 650 ml, the ratio reached 58 %. Conclusion It is after total knee arthro- plasty hidden blood loss is relatively high, almost reached the dominant loss half, drainage and blood transfusion can not satisfy the body recovery cycle needs, therefore need to replenish the blood volume, the occult blood loss in the correct analysis helps to improve clinical assessment skills, help in total knee arthroplasty patients can smoothly through the operation period.

关 键 词：全膝关节置换术 隐性失血 

分 类 号：R687[医药卫生—骨科学]