全膝关节置换术围手术期失血量的临床相关性研究

发布时间：2018-05-08 19:26

本文选题：全膝关节置换术 + 围手术期失血量　；参考：《山东中医药大学》2015年硕士论文

【摘要】：目的:通过临床病例的观察,研究全膝关节置换术的围手术期出血量的临床相关性因素。方法:对山东中医药大学附属医院(山东省中医院)关节骨科2013.05-2015.01同一组医师完成的全膝关节置换术的患者48例(50膝)进行回顾、总结、分析,记录其各项相关性因素,包括身高、体重、体重指数,是否合并内科基础疾病,影像学分级,假体类型、手术入路等,根据患者自身体重、身高以及术前术后血液检验数据患者计算围手术期失血量,根据统计学分析,研究其临床相关性。结果:48例(50膝)病人均手术顺利,术后恢复良好,切口均I/甲级愈合,未出现感染、脱位、假体周围骨折等现象。48例(50膝)全膝关节置换围手术期总失血量波动在平均为652.58±102.70ml。所有病例均输注悬浮红细胞2u((1 U=200 mL全血容量),临床资料证明,年龄、体重指数,是否合并内科基础疾病,影像学分级,膝关节置换假体类型在全膝关节置换术围手术期失血量方面差异有统计学意义,表明患者年龄在70岁以上,体重指数大于30Kg/m2,合并内科基础疾病,影像学分级等级越高,术中应用后交叉韧带切除型-PS假体等因素导致了围手术期失血量的增加,而手术入路在全膝关节置换术围手术期失血量方面差异无统计学意义。结论:年龄、体重指数,是否合并内科基础疾病,影像学分级及全膝关节置换术假体类型均与全膝关节置换术围手术期失血量存在相关性。
[Abstract]:Objective: to study the clinical correlation factors of perioperative bleeding in total knee arthroplasty (TKA). Methods: 48 cases (50 knees) of total knee arthroplasty performed by the same group of physicians in the Department of Joint Orthopaedics, Shandong University of traditional Chinese Medicine (Shandong Provincial Hospital of traditional Chinese Medicine) were reviewed, analyzed and recorded. They include height, weight, body mass index, whether or not they are associated with basic internal diseases, imaging classification, prosthesis type, surgical approach, etc. The perioperative blood loss is calculated according to the patient's own weight, height and blood test data before and after surgery. According to statistical analysis, the clinical correlation was studied. Results the operation was successful in 48 cases with 50 knees. The postoperative recovery was good. All the incisions healed without infection, dislocation and fracture around the prosthesis. The total blood loss fluctuated in the average of 652.58 卤102.70 ml during the perioperative period of total knee arthroplasty. All patients were infused with 200 mL whole blood volume of suspended red blood cell (2u((1). The clinical data showed that age, body mass index (BMI), whether the patients were complicated with basic diseases of internal medicine, imaging grade, or not. The type of knee arthroplasty prosthesis was significantly different in perioperative blood loss after total knee arthroplasty, indicating that the patients were over 70 years old, had a body mass index (BMI) of more than 30 kg / m ~ (2), complicated with basic diseases of internal medicine, and the higher the grade of imaging grade was. The application of posterior cruciate ligament resected prosthesis and other factors resulted in the increase of blood loss in perioperative period, but there was no significant difference between operative approach and perioperative blood loss in total knee arthroplasty. Conclusion: age, body mass index (BMI), basic medical diseases, imaging grade and prosthesis type of total knee arthroplasty are correlated with perioperative blood loss of total knee arthroplasty.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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