极低的输血率：当代初次全髋关节和膝关节置换术。
Extremely Low Transfusion Rates: Contemporary Primary Total Hip and Knee Arthroplasties.
机构信息
Ortho Center Göteborg, Gothenburg, Sweden.
出版信息
J Arthroplasty. 2018 Jan;33(1):51-54. doi: 10.1016/j.arth.2017.07.034. Epub 2017 Jul 29.
BACKGROUND
Considerable blood loss which requires transfusion is frequently reported after total hip and knee arthroplasties (THA and TKA). The purpose of this study is to review the transfusion rates in contemporary THA and TKA with optimized perioperative protocols including minimized surgical trauma and optimal perioperative patient care.
METHODS
This retrospective study included 1442 consecutive patients receiving either a primary THA or a TKA from the same high-volume surgeon between January 2008 and December 2015. Demographics and surgical data were collected from patients' journals. Estimated blood loss, decline in hemoglobin, and use of transfusion were registered.
RESULTS
One (0.0013%) THA and 3 (0.0044%) TKAs required blood transfusion postoperatively. Average measured bleeding was 253 mL ± 142 and 207 mL ± 169 in THA and TKA, respectively. Average decline in hemoglobin was 23.5 g/L ± 11.4 and 22.9 g/L ± 11.6 for THA and TKA, respectively.
CONCLUSION
In contemporary THA and TKA, perioperative protocols and patient optimization can decrease the rate of blood transfusion to near zero.
背景
全髋关节置换术（THA）和全膝关节置换术（TKA）后常报告大量失血需要输血。本研究的目的是回顾优化围手术期方案（包括最小化手术创伤和优化围手术期患者护理）后当代 THA 和 TKA 的输血率。
方法
本回顾性研究纳入了 2008 年 1 月至 2015 年 12 月期间由同一位高容量外科医生进行的 1442 例连续初次 THA 或 TKA 患者。从患者病历中收集了人口统计学和手术数据。登记了估计失血量、血红蛋白下降和输血使用情况。
结果
1 例（0.0013%）THA 和 3 例（0.0044%）TKA 术后需要输血。THA 和 TKA 的平均实际出血量分别为 253 ± 142mL 和 207 ± 169mL。THA 和 TKA 的血红蛋白平均下降量分别为 23.5 ± 11.4g/L 和 22.9 ± 11.6g/L。
结论
在当代 THA 和 TKA 中，围手术期方案和患者优化可将输血率降低至接近零。
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