术中自体血回输在全髋关节置换术中的安全性和有效性研究

发布时间：2019-03-03 17:39

【摘要】：[目的]评价在现代血液管理策略干预下,术中自体血回输在初次单侧全髋关节置换术(total hip arthro-plasty,THA)快速康复中的安全性和有效性。[方法]设定纳入与排除标准,回顾性纳入2015年1月~2016年1月,于四川大学华西医院关节外科行初次单侧THA的患者130例,其中手术过程中使用了自体血液回输装置的70例患者作为回输组,未使用的60例患者作为对照组。[结果]两组患者的凝血功能、炎性指标和术后并发症的发生率差异无统计学意义(P0.05)。回输组的术中出血量多于对照组[(259.73±189.50)ml vs(118.25±56.47)ml,P0.001],术后24 h引流量多于对照组[(274.43±153.31)ml vs(193.64±88.62)ml,P=0.031],两组患者术后第1 d的血红蛋白(hemoglobin,HB)和血细胞比容(hematocrit,HCT)下降量差异无统计学意义(P0.05),术后贫血发生率差异无统计学意义(P=0.558),回输组术后第3 d的HB和HCT下降量多于对照组(P0.05),异体输血率差异无统计学意义(4.29%vs 0%,P=0.300)。[结论]基于快速康复外科理念,在现代血液管理策略干预下,对于术中出血量多、手术时间长的复杂初次单侧THA,术中自体血回输不会改变患者的凝血功能和炎性指标,不会增加术后并发症的发生率。术中自体血回输可以减少患者血红蛋白的丢失,防止HB和HCT快速下降,降低术后贫血的发生率。
[Abstract]:[objective] to evaluate the safety and efficacy of intraoperative autotransfusion in the rapid rehabilitation of primary unilateral total hip arthroplasty (total hip arthro-plasty,THA) under the intervention of modern blood management strategy. [methods] the inclusion and exclusion criteria were set and included retrospectively in 130 patients with first unilateral THA in Huaxi Hospital of Sichuan University from January 2015 to January 2016. 70 patients with autologous blood transfusion device were used as the transfusion group, and 60 patients who were not used as the control group. [results] there was no significant difference in coagulation function, inflammatory index and postoperative complications between the two groups (P0.05). The intraoperative bleeding volume in the re-transfusion group was more than that in the control group [(259.73 卤189.50) ml vs (118.25 卤56.47) ml,P0.001], and the drainage volume at 24 h after operation was more than that in the control group [(274.43 卤153.31) ml vs (193.64 卤88.62) ml,P=0.031]. There was no significant difference in the decrease of hemoglobin (hemoglobin,HB) and hematocrit (hematocrit,HCT) on the first day after operation between the two groups (P0.05), and there was no significant difference in the incidence of anemia between the two groups (P < 0. 558). The decrease of HB and HCT in the re-transfusion group on the 3rd day after operation was higher than that in the control group (P0.05), but there was no significant difference in the allogeneic blood transfusion rate (4.29%vs 0%, P < 0. 300). [conclusion] based on the idea of rapid rehabilitation surgery, under the intervention of modern blood management strategy, the coagulation function and inflammatory parameters of patients with complicated unilateral THA, which have more bleeding volume and longer operation time, will not be changed by intraoperative autotransfusion. It does not increase the incidence of postoperative complications. Intraoperative autotransfusion can reduce the loss of hemoglobin, prevent the rapid decrease of HB and HCT, and reduce the incidence of postoperative anemia.
【作者单位】：四川大学华西医院骨科;
【基金】：卫生部年度卫生行业科研专项项目(编号:201302007)
【分类号】：R687.4

【相似文献】