Song Joo-Hyoun, Han Suk Ku, Lee Kyung-Hoon, Lee Jae-Min, Lee Kee-Haeng
Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
Hip Pelvis. 2015 Sep;27(3):141-5. doi: 10.5371/hp.2015.27.3.141. Epub 2015 Sep 30.
The purpose of this study is to compare the perioperative blood loss in primary non-cemented total hip arthroplasty (THA) performed for rapidly destructive coxarthrosis (RDC) with the perioperative blood loss in primary non-cemented THA for typical osteonecrosis of the femoral head (ONFH).
From January 2000 to December 2013, 19 patients were diagnosed with RDC (group 1) and 40 patients were diagnosed typical Ficat stage IV ONFH (group 2), comparison of perioperative blood loss between group 1 and group 2 in primary noncemented THA was done. Patients with preoperative usage of steroid or anticoagulants medication and with hemodynamic abnormal blood test results were excluded. The blood loss was measured up to the fifth post operation day and calculated with formula proposed by Mercuriali, Inghilleri and Nadler.
Non-compensated blood loss calculated in milliliters of red blood cells was 362 mL (standard deviation [SD], 187; range, 77-675) in group 1 and 180 mL (SD, 145; range, 53-519) in group 2. Compensated blood loss was 630 mL (SD, 180; range, 380-760) in group 1 and 503 mL (SD, 260; range, 190-1, 505) in group 2. The total blood loss after primary non-cemented THA is greater when surgery is performed for RDC than for ONFH, with the volume of 992 mL (SD, 300; range, 457-1, 434) in group 1 and 683 mL (SD, 360; range, 226-1, 975) in group 2 respectively.
Total perioperative blood loss was significantly greater in RDC than in ONFH in primary non-cemented THA.
本研究旨在比较为快速破坏性髋关节病（RDC）行初次非骨水泥型全髋关节置换术（THA）的围手术期失血量与为典型股骨头缺血性坏死（ONFH）行初次非骨水泥型THA的围手术期失血量。
2000年1月至2013年12月，19例患者被诊断为RDC（第1组），40例患者被诊断为典型的Ficat IV期ONFH（第2组），对两组患者在初次非骨水泥型THA中的围手术期失血量进行比较。排除术前使用类固醇或抗凝药物以及血液动力学检查结果异常的患者。术后第5天测量失血量，并采用Mercuriali、Inghilleri和Nadler提出的公式进行计算。
第1组以红细胞毫升数计算的未代偿失血量为362 mL（标准差[SD]，187；范围，77 - 675），第2组为180 mL（SD，145；范围，53 - 519）。第1组的代偿失血量为6,30 mL（SD，180；范围，380 - 760），第2组为503 mL（SD，260；范围，190 - 1,505）。为RDC行初次非骨水泥型THA后的总失血量大于为ONFH行手术，第组1的总量为992 mL（SD，300；范围，457 - 1,434），第组2为683 mL（SD，360；范围，226 - 1,975）。
在初次非骨水泥型THA中，RDC患者的围手术期总失血量显著多于ONFH患者。
