Su E P, Su S
Hospital for Special Surgery, 535 East 70th Street, New York, 10021, USA.
Bone Joint J. 2016 Jan;98-B(1 Suppl A):98-100. doi: 10.1302/0301-620X.98B.36430.
During the last ten years, greater attention has been given to the management of peri-operative blood loss after total knee arthroplasty (TKA), as it is a modifiable outcome that has a significant effect on the rate of complications, the recovery, and the economic burden. Blood loss after TKA has been greatly reduced during this time, thereby dramatically reducing the rates of allogeneic transfusion. This has significantly reduced the complications associated with transfusion, such as fluid overload, infection, and increased length of stay. The greatest advent in lowering peri-operative blood loss after TKA has been the introduction of tranexamic acid, which reduces blood loss without increasing the risk of thromboembolic events. This paper discusses the ways of reducing blood loss after TKA, for which a multimodal algorithm, with pre-, intra- and post-operative measures, has been adopted at our institution.
在过去十年中，全膝关节置换术（TKA）围手术期失血的管理受到了更多关注，因为这是一个可调节的结果，对并发症发生率、恢复情况和经济负担都有重大影响。在此期间，TKA后的失血量已大幅减少，从而显著降低了异体输血率。这显著减少了与输血相关的并发症，如液体超负荷、感染和住院时间延长。降低TKA术后围手术期失血量的最大进展是引入了氨甲环酸，它能减少失血量而不增加血栓栓塞事件的风险。本文讨论了减少TKA术后失血的方法，为此我们机构采用了一种包含术前、术中和术后措施的多模式算法。
