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[全膝关节或髋关节置换术患者术后血液恢复情况]

[Postoperative recovery of blood in patients undergoing total knee or hip arthroplasty].

作者信息

Laranjeira Hugo, Coimbra Celeste, Fernandes Nuno, Pinho Romeu, Anjos Rui, Mesquita Elisabeth, Barros António, Ferreira Rita, Borges Lúcia

机构信息

Serviço de Imunohemoterapia. Centro Hospitalar do Baixo Vouga, E.P.E. Aveiro. Portugal. Departamento de Química. Universidade de Aveiro. Aveiro. Portugal.

出版信息

Acta Med Port. 2013 Sep-Oct;26(5):511-6. Epub 2013 Oct 31.

Abstract

BACKGROUND

In total knee arthroplasty and total hip arthroplasty occurs a considerable loss of blood, which often requires homologous transfusions of red blood cells. However, homologous transfusions have risks, besides being expensive and a limited resource. Thus, in order to reduce the need for homologous transfusions alternatives strategies have been developed, like post-operative recovery of blood.

OBJECTIVES

Evaluation of post-operative recovery of blood in postoperatively red blood cells consumption and in hospital stay, by a retrospective analysis of patients undergoing total knee arthroplasty or total hip arthroplasty.

MATERIAL AND METHODS

Patients (n = 976) were divided in 2 groups: CELL TRANS - after implementation of postoperative recovery of blood and CONT - before implementation of the strategy. The red blood cells requests to Serviço de Imunohemoterapia gave the number of RBC units administered and the length of hospital stay was obtained through the Sistema de Apoio ao Médico. Statistical analysis was performed using the R language, considering significant differences between groups when p values < 0,05.

RESULTS

After the introduction of this strategy, 29% of patients undergoing total knee arthroplasty and 38% of patients undergoing total hip arthroplasty received red blood cells in the postoperative period, a number considerably lower to that observed before the implementation of post-operative recovery of blood, 68% and 59% respectively. Concomitantly, there was a statistically significant reduction in the length of stay of 9.0 to 8.3 days in the case of total knee arthroplasty patients and from 9.1 to 8.8 days in the case of patients undergoing total hip arthroplasty.

CONCLUSION

Post-operative recovery of blood in patients undergoing total knee arthroplasty or total hip arthroplasty significantly reduces the need for red blood cells transfusion and the length of hospital stay.

摘要

背景

全膝关节置换术和全髋关节置换术会出现大量失血,这通常需要输注同源红细胞。然而,同源输血除了成本高且资源有限外,还存在风险。因此,为了减少对同源输血的需求,已开发出替代策略,如术后血液回收。

目的

通过对接受全膝关节置换术或全髋关节置换术的患者进行回顾性分析,评估术后血液回收对术后红细胞消耗和住院时间的影响。

材料与方法

将976例患者分为两组:CELL TRANS组——实施术后血液回收后;CONT组——实施该策略前。向免疫血液治疗服务部门申请的红细胞数量即为输注的红细胞单位数量,住院时间通过医疗支持系统获取。使用R语言进行统计分析,当p值<0.05时认为两组间存在显著差异。

结果

引入该策略后,接受全膝关节置换术的患者中有29%在术后接受了红细胞输注,接受全髋关节置换术的患者中有38%在术后接受了红细胞输注,这一数字显著低于实施术后血液回收前观察到的数字,分别为68%和59%。同时,全膝关节置换术患者的住院时间从9.0天显著缩短至8.3天,全髋关节置换术患者的住院时间从9.1天显著缩短至8.8天。

结论

全膝关节置换术或全髋关节置换术患者的术后血液回收显著减少了红细胞输血需求和住院时间。

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