单侧全髋关节置换术围手术期总失血量的相关影响因素分析

摘要

Objective:To investigate the influential factors of total blood loss during unilateral artificial total hip arthroplasty (THA).Methods:From January 2014 to July 2016,131 patients undergwent primary unilateral total hip arthroplasty,including 55 males and 76 females,ranging in age from 40 to 89 years old,with an average of 64.5 years old.The data of patients with unilateral total hip arthroplasty were collected,and the data of hemodynamics,coagulation function,hemoglobin and hematocrit values were recorded according to the observation data.The blood loss of the patients was calculated by Gross equation,and the data were analyzed by a statistical software.Results:The total blood loss of the patients was significantly affected by the factors of pathogenesis and deep venous thrombosis of the lower limbs.The results were statistically significant (P＜0.05).The gender,age,body mass index,prosthesis and anesthesia had little effects on the blood loss volume after replacement.Conclusion:The data in this study indicate that the volume of actual blood loss can be controlled by adjusting non-surgical factors such as gender,age,body mass index,prosthetic material,and risk factors,and surgical factors (postoperative complications,anesthesia).%目的:探讨单侧人工全髋关节置换围术期总失血量的相关影响因素.方法:搜集我院2014年1月至2016年7月行单侧人工全髋关节置换患者病例,共131例,男55例,女76例;年龄40～89岁,平均64.5岁.根据观测指标记录患者的一般资料、凝血功能指标、术前术后血红蛋白值和红细胞压积值变化情况,利用Gross方程计算出患者围术期失血量,采用统计学软件进行数据分析.结果:全髋关节置换后患者的实际失血量受发病因素、下肢深静脉血栓因素的影响(P＜0.05),而性别、年龄、体重指数、假体材料、麻醉方式对置换后失血量形成的影响不大.结论:全髋关节置换术实际失血的程度可以通过调整非手术因素(如性别、年龄、体重指数、假体材料、发病因素)和手术中的人为因素(术后并发症、麻醉方式等)得到控制.