快速康复外科对全膝关节置换术后血液内环境的影响  

Effect of enhanced recovery after surgery on blood environment after total knee arthroplasty

作　　者：潘建科 黄和涛[2] 杨伟毅 刘军 曾令烽 梁桂洪 陈红云 曹学伟 PAN Jian-ke;HUANG He-tao;YANG Wei-yi;LIU Jun;ZENG Ling -feng;LIANG Gui-hong;CHEN Hong-yun;CAO Xue-wei(Department of Joint Surgery,Second Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,Guangdong,China)

机构地区：[1]广州中医药大学第二附属医院,广东省中医院骨关节科,广东广州510120 [2]广州中医药大学第二临床医学院,广东广州510405

出　　处：《广东医学》2019年第9期1205-1211,共7页Guangdong Medical Journal

基　　金：广东省财政厅项目经费(编号:[2014]157号;[2018]8号);广东省中医院中医药科学技术研究专项(编号:YK2013B2N19;YN2015MS15)

摘　　要：目的快速康复外科对全膝关节置换术后血液内环境的影响。方法采用回顾性病例研究方法,对217例运用快速康复外科方案的全膝关节置换术患者的白细胞、血红蛋白、血小板、总蛋白、白蛋白、凝血、D-二聚体、超敏C反应蛋白、红细胞沉降率(ESR)等相关血液指标进行分析。结果运用快速康复外科方案的全膝关节置换术患者与既往研究中未使用该方案的患者相比,患者术后白细胞峰值时间更短,红细胞及血红蛋白丢失更少,血小板、凝血酶、纤维蛋白等在机体损伤后重新达到平衡的时间更快,白蛋白及总蛋白在术后均有一定下降,但术后3 d开始逐渐回升。结论快速康复外科方案对全膝关节置换术后血液内环境的稳态恢复具有一定的促进作用,值得临床推广使用。Objective To investigate the effect of enhanced recovery after surgery( ERAS) on the blood environment after total knee arthroplasty( TKA). Methods Retrospective case study was performed on 217 patients with total knee arthroplasty with ERAS. Blood indicators,including white blood cells( WBCs),hemoglobin,platelets,total protein,albumin,coagulation,D-dimer,CRP,and ESR,were analyzed. Results A shorter WBC peak duration,less RBC and hemoglobin loss,and more rapid recovery of platelets,thrombin,and fibrin were observed in TKA patients with ERAS. Both albumin and total protein decreased after surgery,but gradually recovered after 3 days. Conclusion The ERAS scheme can promote the homeostasis of blood environment after TKA and is worthy of clinical application.

关 键 词：快速康复外科 全膝关节置换术 血液内环境 

分 类 号：R687.4[医药卫生—骨科学] R493[医药卫生—外科学]