From Rush University Medical Center, Chicago, IL (Dr. Levine, Dr. Haughom, Dr. Hellman, and Dr. Frank), and the University of Rochester Medical Center, Department of Orthopaedics and Rehabilitation, Rochester, NY (Dr. Strong).
J Am Acad Orthop Surg. 2014 Jun;22(6):361-71. doi: 10.5435/JAAOS-22-06-361.
Perioperative blood loss during total knee arthroplasty can be significant, with magnitudes typically ranging from 300 mL to 1 L, with occasional reports of up to 2 L. The resultant anemia can lead to severe complications, such as higher rates of postoperative infection, slower physical recovery, increased length of hospital stay, and increased morbidity and mortality. Although blood transfusions are now screened to a greater extent than in the past, they still carry the inherent risks of clerical error, infection, and immunologic reactions, all of which drive the need to develop alternative blood management strategies. Thorough patient evaluation is essential to individualize care through dedicated blood management and conservation pathways in order to maximize efficacy and avoid associated complications. Interventions may be implemented preoperatively, intraoperatively, and postoperatively.
全膝关节置换术中的围手术期失血可能会很显著，其程度通常在 300 毫升至 1 升之间，偶尔有报告高达 2 升。由此导致的贫血可能会引发严重的并发症，如更高的术后感染率、更慢的身体恢复、更长的住院时间，以及更高的发病率和死亡率。尽管现在对输血的筛查比过去更加严格，但它们仍然存在文书错误、感染和免疫反应等固有风险，这些都促使人们需要开发替代的血液管理策略。通过专门的血液管理和保存途径对患者进行彻底的评估对于实现个体化护理至关重要，这样才能最大限度地提高疗效并避免相关并发症。干预措施可以在术前、术中和术后实施。
