摘要
背景:全膝关节置换术是治疗终末期膝关节疾病的有效方法,然而很多患者因为术后失血而发生急性失血性贫血,失血过多者还需输血治疗。这不仅影响膝关节功能康复,还可能引起各种并发症及相关问题。目的:探讨股骨远端髓外定位截骨是否能够减少初次单侧全膝关节置换术后失血。方法:选取2015年1月至2017年12月248例行初次单侧全膝关节置换术患者,根据纳入、排除标准筛选出198例入组,其中髓外定位组102例,髓内定位组96例。采用回顾性研究方法比较两组患者术后总失血量、引流量、血红蛋白值和异体血输血率,评价股骨远端髓外与髓内定位截骨对全膝关节置换术后失血的影响。结果:髓外定位组的总失血量、引流量均显著低于髓内定位组[(739±225)ml vs(896±301)ml,(148±99)ml vs(209±132)ml,P<0.05],术后第2天血红蛋白平均值显著高于髓内定位组[(103.5±21.5)g/L vs(95.8±29.6)g/L,P<0.05]。髓外定位组异体血输血率低于髓内定位组(0.98%vs 7.29%),但差异不具有统计学意义(P>0.05)。结论:与股骨远端髓内定位截骨比较,髓外定位截骨能够显著减少全膝关节置换术后失血以及血红蛋白降低。
Background:Total knee arthroplasty is an effective method to treat end-stage knee joint diseases.However,many patients get an acute anemia because of blood loss after total knee arthroplasty,and someone who lost too much blood might accept allogenic transfusion,which will affect the recovery of the knee joint and lead to potential complications and related problems.Objective:To explore whether femoral extramedullary alignment osteotomy could reduce blood loss after unilateral primary total knee arthroplasty.Methods:A total of 248 patients who underwent unilateral primary total knee arthroplasty from Janu?ary 2015 to December 2017 were retrospectively analyzed in this study.Eventually 198 patients were enrolled and divided into extramedullary alignment group(n=102)and intramedullary alignment group(n=96).The total blood loss,drainage volume,hemoglobin level and allogenic blood transfusion rate were compared between the two groups.Results:The mean total blood loss and drainage volume were significantly less in the extramedullary alignment group than those in the intramedullary alignment group([739±225]ml vs[896±301]ml,[148±99]ml vs[209±132]ml,P<0.05).Hemoglobin level on day 2 after surgery was significantly higher in the extramedullary alignment group than that in the intramedullary alignment group[103.5±21.5]g/L vs[95.8±29.6]g/L,The extramedullary group had a lower prevalence of allogenic transfusion rate than intramedullary group,but there was no significant difference between two groups(0.98%vs 7.29%,P>0.05).Conclusions:Compared with intramedullary alignment osteotomy,extramedullary alignment osteotomy can effectively reduce total blood loss and hemoglobin decrease in primary total knee arthroplasty.
作者
单鹏程
何名江
胡佩岩
艾奇
荆琳
张洪美
SHAN Pengcheng;HE Mingjiang;HU Peiyan;AI Qi;JING Lin;ZHANG Hongmei(First Orthopeadic Department,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中华骨与关节外科杂志》
2021年第1期21-24,共4页
Chinese Journal of Bone and Joint Surgery
基金
2019年首都临床诊疗技术研究及示范应用项目(Z191100006619023)。
关键词
全膝关节置换
股骨
髓外定位截骨
失血量
Total Knee Arthroplasty
Femur
Extramedullary Alignment Osteotomy
Blood Loss
