全膝关节置换术后输血现状以及影响因素分析  

Analysis of Current Status and Influencing Factors of Blood Transfusion After Total Knee Arthroplasty

作　　者：晏征 张金庆[2] 杨德金[2] YAN Zheng;ZHANG Jinqing;YANG Dejin(Department of Joint Reconstruction,Beijing Chaoyang Emergency Medical Center Hospital,Beijing 100122,China;Department of Joint Reconstruction,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京朝阳急诊抢救中心矫形骨科,北京100122 [2]北京积水潭医院矫形骨科,北京100035

出　　处：《中国继续医学教育》2021年第11期148-151,共4页China Continuing Medical Education

基　　金：北京积水潭医院青年人才培养“学科新星”计划。

摘　　要：目的分析全膝关节置换术(TKA)后输血现状以及影响因素。方法本研究为病例登记注册研究,选取人工关节登记中心2019年1—12月单侧全膝关节置换手术的患者1079例。按照术后是否输血对患者进行分组。分析全膝关节置换术后输血患者的比例与两组患者在年龄、性别、体质量指数(BMI)、美国麻醉医师协会(American Society of Anesthesiology,ASA)评分、术前红细胞压积、术前血红蛋白、氨甲环酸使用情况、有无慢性合并症、手术时间、住院时间、术前总蛋白之间的差异。结果全膝关节置换术后输血患者54例,占5.0%。单因素分析结果认为,高龄、麻醉评分、术前红细胞压积、氨甲环酸、术前血红蛋白影响术后输血率(P<0.05)。Logistic回归结果显示,术后使用氨甲环酸、术前血红蛋白异常是影响TKA术后输血的独立影响因素(P<0.05)。结论重视围手术期管理、提升整体手术技术水平是降低输血率的关键。Objective To analyze the current status of blood transfusion after total knee arthroplasty(TKA)and its influencing factors.Methods From January to December 2019,this study is a case registration study,selecting 1079 patients undergoing unilateral total knee replacement surgery at the artificial joint registration center.Patients were grouped according to whether or not they were transfused after surgery.Analyze the proportion of blood transfusion patients after total knee arthroplasty and the two groups of patients in terms of age,gender,body mass index(BMI),American Society of Anesthesiology(ASA)score,preoperative hematocrit,preoperative hemoglobin,The difference between tranexamic acid usage,chronic comorbidities,operation time,hospital stay,and total protein before operation.Results 54 patients with blood transfusion after total knee replacement,accounting for 5.0%.Univariate analysis showed that advanced age,anesthesia score,preoperative hematocrit,tranexamic acid,and preoperative hemoglobin affected the postoperative blood transfusion rate(P<0.05).Logistic regression results showed that postoperative use of tranexamic acid and preoperative hemoglobin abnormalities were independent factors affecting blood transfusion after TKA(P<0.05).Conclusion Paying attention to perioperative management and improving the overall surgical technique is the key to reducing blood transfusion rate.

关 键 词：关节成形术 置换 膝 危险因素 输血 登记注册研究 

分 类 号：R687[医药卫生—骨科学]