髋关节和膝关节置换术后的隐性失血。正确处理失血情况应考虑隐性失血。

Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account.

作者信息

Sehat K R, Evans R L, Newman J H

机构信息

Southmead Hospital, Bristol, England, UK.

出版信息

J Bone Joint Surg Br. 2004 May;86(4):561-5.

PMID:15174554

Abstract

Following total hip arthroplasty (THA) and total knee arthroplasty (TKR) only the 'visible' measured blood loss is usually known. This underestimates the 'true' total loss, as some loss is 'hidden'. Correct management of blood loss should take hidden loss into account. We studied 101 THAs and 101 TKAs (with re-infusion of drained blood). Following THA, the mean total loss was 1510 ml and the hidden loss 471 ml (26%). Following TKA, the mean total loss was 1498 ml. The hidden loss was 765 ml (49%). Obesity made no difference with either operation. THA involves a small hidden loss, the total loss being 1.3 times that measured. However, following TKA, there may be substantial hidden blood loss due to bleeding into the tissues and residual blood in the joint. The true total loss can be determined by doubling the measured loss.

摘要

在全髋关节置换术（THA）和全膝关节置换术（TKR）后，通常仅知道“可见”的测量失血量。这低估了“真实”的总失血量，因为一些失血量是“隐藏”的。对失血的正确管理应考虑隐藏的失血量。我们研究了101例全髋关节置换术和101例全膝关节置换术（采用引流血回输）。全髋关节置换术后，平均总失血量为1510毫升，隐藏失血量为471毫升（26%）。全膝关节置换术后，平均总失血量为1498毫升。隐藏失血量为765毫升（49%）。肥胖对这两种手术均无影响。全髋关节置换术的隐藏失血量较少，总失血量是测量失血量的1.3倍。然而，全膝关节置换术后，由于血液渗入组织和关节内残留血液，可能存在大量隐藏失血量。真实的总失血量可以通过将测量失血量加倍来确定。