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在腰麻-硬膜外联合麻醉下行全髋关节翻修置换术时的大量输血

Massive Blood Transfusion during Revision Total Hip Arthroplasty under Combined Spinal Epidural Anaesthesia.

作者信息

Kandemir Tünay, Kandemir Erbin, Aşkın Tuğba, Dal Tülay, Kılıç Yeliz, Ünver Süheyla

机构信息

Clinic of Anaesthesia, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2016 Feb;44(1):54-6. doi: 10.5152/TJAR.2016.32858. Epub 2016 Feb 1.

Abstract

Revision total hip arthroplasty (THA) is an orthopaedic surgery that is known to be associated with excessive bleeding. The rates of mortality and morbidity are high in patients with massive haemorrhage. The patient in this study was administered blood products with high fresh frozen plasma/red blood cell (RBC) suspension ratio and high platelet/RBC suspension ratio without waiting for haemostasis test results. This study suggests that this approach might prove beneficial in reducing the incidence of intra- and postoperative complications. this study presents our experience with a patient who underwent THA and required a transfusion that was three times her estimated total blood volume. The patient was successfully managed with close monitoring of haemorrhage and timely administration of blood and blood products before hypotension and loss of consciousness occurred.

摘要

翻修全髋关节置换术(THA)是一种已知与大量出血相关的骨科手术。大出血患者的死亡率和发病率很高。本研究中的患者在未等待止血测试结果的情况下,接受了高新鲜冰冻血浆/红细胞(RBC)悬浮液比例和高血小板/RBC悬浮液比例的血液制品。本研究表明,这种方法可能有助于降低术中和术后并发症的发生率。本研究介绍了我们对一名接受THA手术且所需输血量为其估计全血容量三倍的患者的治疗经验。通过密切监测出血情况,并在发生低血压和意识丧失之前及时输注血液和血液制品,该患者得到了成功救治。

相似文献

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Transfusion practice in hip arthroplasty--a nationwide study.髋关节置换术的输血实践——一项全国性研究。
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Recent Trends in Blood Utilization After Revision Hip and Knee Arthroplasty.翻修髋膝关节置换术后血液利用的最新趋势。
J Arthroplasty. 2017 Dec;32(12):3693-3697. doi: 10.1016/j.arth.2017.08.038. Epub 2017 Sep 5.

本文引用的文献

2
Current management of massive hemorrhage in trauma.创伤性大出血的当前处理方法。
Scand J Trauma Resusc Emerg Med. 2012 Jul 9;20:47. doi: 10.1186/1757-7241-20-47.
3
Massive Bleeding and Massive Transfusion.大出血与大量输血
Transfus Med Hemother. 2012 Apr;39(2):73-84. doi: 10.1159/000337250. Epub 2012 Mar 12.

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