膝骨性关节炎影像分级对全膝置换术后隐性失血的影响与自体血储备  

The effect of knee osteoarthritis on the hidden blood loss after total knee arthroplasty

作　　者：何敏[1] 彭炳龙[1] 刘水红[2] 杨慧文[1] 田会军[1] 张勇[3] 高志增[4] 

机构地区：[1]江西省萍乡市人民医院关节外科,江西萍乡337000 [2]江西省萍乡市人民医院检验科,江西萍乡337000 [3]江西省萍乡市人民医院输血科,江西萍乡337000 [4]南昌大学第一附属医院关节外科,江西南昌330000

出　　处：《中国当代医药》2016年第32期62-64,共3页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20167175)

摘　　要：目的 探讨膝骨性关节炎影像分级对全膝置换术后隐性失血的影响,为择期进行全膝置换术患者提供自体血储备方面提供临床参考。方法 选取2015年8月～2016年7月在本院行初次单侧TKA术患者患者68例,根据Kellgren和Lawrence影像学分级标准进行分级：Ⅲ级28例,Ⅳ级40例,统计影像学分级与隐性失血量的关系。结果Ⅳ级组输血量、输血率以及同种异体血输血率均显著高于Ⅲ级组（P〈0.05）;Ⅳ级总失血量和隐性失血量均显著高于Ⅲ级（P〈0.05）,两组隐性失血率比较,差异无统计学意义（P〉0.05）。结论 全膝关节置换术前对患者进行影像学分级能够帮助手术医师评估围术期出血情况,做好血液管理,对于保护患者生命安全具有重要意义。Objective To explore the effect of imaging classification of knee osteoarthritis on occult blood loss after total knee arthroplasty,for providing clinical reference for the treatment of patients with total knee arthroplasty.Methods68 cases of patients treated by primary unilateral TKA in our hospital from August 2015 to July 2016 were selected.According to Kellgren and Lawrence imaging classification standard for grading,The relationship between imaging classification and invisible blood loss was analyzed,Ⅲ class was 28 cases,Ⅳ class was 40 cases.Results The amount of blood transfusion,blood transfusion rate,blood transfusion rate,total blood loss and hidden blood loss of grade Ⅳ were significantly higher than those of grade Ⅲ（P〈0.05）.There was no significant difference in occult blood loss rate between the two groups（P〉0.05）.Conclusion Preoperative imaging classification of patients undergoing total knee arthroplasty can help surgeons to evaluate perioperative bleeding,and do a good job in blood management,which is of great significance for the protection of the life safety of patients.

关 键 词：膝骨性关节炎 影像分级 全膝置换术 隐性失血量 自体血储备 

分 类 号：R816.8[医药卫生—放射医学]