Liu David, Dan Michael, Martinez Martos Sara, Beller Elaine
Gold Coast Centre for Bone and Joint Surgery, Queensland, Australia.
John Hunter Hospital, New South Wales, Australia.
Knee Surg Relat Res. 2016 Sep;28(3):179-87. doi: 10.5792/ksrr.2016.28.3.179. Epub 2016 Aug 25.
A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods and can be employed in various combinations. Recent literature has highlighted the importance of preoperative Hb optimization, minimizing blood loss and evidence-based transfusion guidelines. Given TKA is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal.
围手术期血液管理计划是全膝关节置换术（TKA）中成功进行患者护理的众多重要要素之一，外科医生应积极应用该计划。血液保护的目的是降低输血风险，同时在术后最大限度地提高血红蛋白（Hb）水平，从而对治疗结果和成本产生积极影响。基于患者特定风险因素、预期失血量和合并症的个体化策略有助于实现这一目标。术前、术中和术后阶段有多种血液保护策略可供选择，并且可以以各种组合方式使用。最近的文献强调了术前优化Hb、减少失血量和循证输血指南的重要性。鉴于TKA是一种择期手术，目标应该是实现零异体输血率，这也是一个可以实现的目标。
