全髋关节置换术中保温干预对围手术期出血的影响  

The effect of temperature interventions on perioperative blood loss in total hip replacement

作　　者：覃文杰[1] 尹东[2] 黄宇[2] 黄晓[2] 李富林[1] 

机构地区：[1]广西医科大学,广西南宁530021 [2]广西壮族自治区人民医院骨科,广西南宁530021

出　　处：《中国矫形外科杂志》2015年第17期1542-1545,共4页Orthopedic Journal of China

基　　金：广西医药卫生科研课题(编号:桂卫Z2013363)

摘　　要：[目的]探讨在全髋关节置换术中,运用保温干预措施,了解对围手术期的出血量是否有影响。[方法]将2013年8月∽2014年10月,在本院行非骨水泥型人工全髋关节置换术的患者,共60髋,随机分为两组,每组各30髋。体温干预组采取可控式电热保温毯、输入液加温等措施,维持患者体温在36℃以上;对照组不做特别处理。两组患者均在术后48∽72 h内拔除引流管,评估两组患者手术中出血量及术后引流量情况,以及术前、术后血红蛋白含量变化及输血率。[结果]体温干预组术中出血及术后引流量均少于对照组,差异有统计学意义（P〈0.05）。术后24 h血红蛋白水平,体温干预组高于对照组。体温干预组的输血人数及输血率明显少于对照组。[结论]保温干预措施对减少全髋关节置换术的术中出血量、术后引流量及输血率有着明显的效果。[ Objective ] To investigate the effect on perioperative blood loss by using temperature interventions in total hip replacement. [ Methodsl Between August 2013 and October 2014, 60 patients （60 hips） treated in our hospital with uncemeut THA were randomized into two groups and 30 hips is in each group. Temperature intervention group maintained the temperature of patients more than 36~C by controllable electric blanket, preheating input liquid and so on. Control group was dealed without special handling. The drainage tube was pulled out in 48 ~ 72 hours after operation and evaluate intraoperative and postoperative blood loss, preoperative and postoperative hemoglobin and the rate of transfusion. [ Results] The intraoperative and postopera- tive blood loss of patients from temperature intervention group were lower than that of patients from the control group and the difference was significant （ P 〈 0. 05 ） . The Hemoglobin concentrations of patients from temperature intervention group were higher than that of patients from control group, and the difference was significant （ P 〈 0. 05 ） . The number and ratio of patients with blood transfusion of patients from temperature intervention group were apparently lower than that of patients from control group, and the difference was significant （P 〈 0.05） . [ Conclusion] Temperature interventions can obviously reduce the in- traoperative, postoperative blood loss and the ratio of blood transfusion in total hip replacement.

关 键 词：全髋关节置换 围手术期 出血 低体温 

分 类 号：R687.4[医药卫生—骨科学]