Gao Fu-qiang, Li Zi-jian, Zhang Ke, Liu Yan-qing, Tian Hua, Liu Yan, Liu Zhong-jun
Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Wai Ke Za Zhi. 2011 May 1;49(5):419-23.
To investigate the relative factors for hidden blood loss (HBL) after primary total knee arthroplasty (TKA).
A retrospective study of 422 consecutive patients who underwent primary TKA between October 2007 and August 2009 was carried on. There were 60 male and 362 female patients with a mean age of 65.7 years. The HBL was calculated according to Gross formula. The effect of patient gender, age, body mass index (BMI), pre-operative diagnosis, unilateral or simultaneous bilateral TKA, tourniquet time, type of prosthesis, postoperative anticoagulation method and deep vein thrombosis (DVT) on the postoperative HBL were analyzed.
The HBL in patients underwent unilateral TKA was significantly lower than that in those underwent simultaneous bilateral TKA [(1284 ± 207) ml vs. (2248 ± 504) ml, P = 0.000]. Unvaried analysis showed that the HBL were associated with BMI, tourniquet time, prosthesis type and postoperative anticoagulation method. Multivariate linear regression analysis showed that the impact factors of postoperative HBL include BMI, tourniquet time and prosthesis type.
BMI, bilateral simultaneous TKA, tourniquet time and intercondylar open prosthesis impact the HBL after primary TKA. However, the influence of gender, age, diagnosis, postoperative anticoagulation method and DVT on the HBL are not significant.
探讨初次全膝关节置换术（TKA）后隐性失血（HBL）的相关因素。
对2007年10月至2009年8月期间连续进行初次TKA的422例患者进行回顾性研究。其中男性60例，女性362例，平均年龄65.7岁。根据Gross公式计算HBL。分析患者性别、年龄、体重指数（BMI）、术前诊断、单侧或同期双侧TKA、止血带时间、假体类型、术后抗凝方法及深静脉血栓形成（DVT）对术后HBL的影响。
单侧TKA患者的HBL显著低于同期双侧TKA患者[（1284±207）ml对（2248±504）ml，P = 0.000]。单因素分析显示，HBL与BMI、止血带时间、假体类型及术后抗凝方法有关。多因素线性回归分析显示，术后HBL的影响因素包括BMI、止血带时间和假体类型。
BMI、双侧同期TKA、止血带时间及髁间开放式假体影响初次TKA后的HBL。然而，性别、年龄、诊断、术后抗凝方法及DVT对HBL的影响不显著。
