Chen Liang-Long, Wang Wan-Chun, Mao Xin-Zhan, Yu Min, Zhu Qi
Department of Orthopaedicsì Second Xiangya Hospital, Central South University, Changsha, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2007 Apr;32(2):316-9.
To analyze the evaluation and treatment of blood loss during total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the aged .
We retrospectively surveyed the blood loss and the rehabilitation of 46 cases of TKA and 146 cases of THA older than 60.
In the group younger than 70, the mean total blood loss of THA was 1425 mL and the hidden hemorrhage 729 mL (51%); following the TKA, the mean total loss was 1386 mL and the hidden hemorrhage was 890 mL (64%). In the group 70 and older, the mean total blood loss of THA was 1435 mL and the hidden hemorrhage was 769 mL (53%)û following the TKA, the mean total loss was 1380 mL and the hidden hemorrhage was 910 mL (65%). The difference of hidden hemorrhage between the THA and the TKA was both significant by different (p< 0.05). Age played an important part in the THA group (p< 0.05), but not in the TKA group (> 0.05).
The aged have poor resistance to blood loss. Hidden hemorrhage in the TKA or THA perhaps is the primary part of the blood loss. Prompt treatment is helpful for the rehabilitation.
分析老年患者全髋关节置换术（THA）和全膝关节置换术（TKA）中失血情况的评估及处理。
回顾性调查46例年龄大于60岁的TKA患者和146例年龄大于60岁的THA患者的失血情况及康复情况。
在70岁以下组，THA的平均总失血量为1425 mL，隐性失血量为729 mL（51%）；TKA后，平均总失血量为1386 mL，隐性失血量为890 mL（64%）。在70岁及以上组，THA的平均总失血量为1435 mL，隐性失血量为769 mL（53%）；TKA后，平均总失血量为1380 mL，隐性失血量为910 mL（65%）。THA和TKA之间隐性失血的差异均具有统计学意义（p<0.05）。年龄在THA组中起重要作用（p<0.05），但在TKA组中不起作用（>0.05）。
老年人对失血的耐受性较差。TKA或THA中的隐性失血可能是失血的主要部分。及时治疗有助于康复。
