经皮辅助囊上入路与后外侧入路全髋关节置换术相比失血量更少。
Less blood loss in supercapsular percutaneously assisted versus posterolateral total hip arthroplasty.
机构信息
Present Address: Department of Joint Surgery, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China.
Present Address: Department of Orthopaedic Surgery, The Third Affiliated Hospital of GuangZhou Medical College, Guangzhou City, Guangdong Province, China.
出版信息
J Orthop Surg Res. 2021 Mar 25;16(1):217. doi: 10.1186/s13018-021-02363-z.
BACKGROUND
Although excellent clinical outcomes of supercapsular percutaneously assisted total hip arthroplasty (SuperPath) have been reported, the peri-operative blood loss has rarely been reported. The current study determined the blood loss during SuperPath and compared the blood loss with conventional posterolateral total hip arthroplasty (PLTH).
METHODS
This retrospective study enrolled patients who underwent unilateral primary THA between January 2017 and December 2019. The demographic data, diagnoses, affected side, radiographic findings, hemoglobin concentration, hematocrit, operative time, transfusion requirements, and intra-operative blood loss were recorded. The peri-operative blood loss was calculated using the OSTHEO formula. Blood loss on the 1st, 3rd, and 5th post-operative days was calculated. Hidden blood loss (HBL) was determined by subtracting the intra-operative blood loss from the total blood loss.
RESULTS
Two hundred sixty-three patients were included in the study, 85 of whom were in the SuperPath group and 178 in the posterolateral total hip arthroplasty (PLTH) group. Patient demographics, diagnoses, affected side, operative times, and pre-operative hemoglobin concentrations did not differ significantly between the two groups (all P > 0.05). Compared to the PLTH group, the SuperPath group had less blood loss, including intra-operative blood loss, 1st, 3rd, and 5th post-operative days blood loss, and HBL (all P < 0.05). Total blood loss and HBL was 790.07 ± 233.37 and 560.67 ± 195.54 mL for the SuperPath group, respectively, and 1141.26 ± 482.52 and 783.45 ± 379.24 mL for the PLTH group. PLTH led to a greater reduction in the post-operative hematocrit than SuperPath (P < 0.001). A much lower transfusion rate (P = 0.028) and transfusion volume (P = 0.019) was also noted in the SuperPath group.
CONCLUSION
SuperPath resulted in less perioperative blood loss and a lower transfusion rate than conventional PLTH.
背景
尽管经皮辅助超囊下单侧全髋关节置换术（SuperPath）具有出色的临床效果，但很少有报道其围手术期的失血量。本研究旨在评估 SuperPath 术式的术中失血量，并与传统后外侧全髋关节置换术（PLTH）进行比较。
方法
本回顾性研究纳入了 2017 年 1 月至 2019 年 12 月期间行单侧初次 THA 的患者。记录患者的人口统计学数据、诊断、患侧、影像学表现、血红蛋白浓度、红细胞压积、手术时间、输血需求以及术中失血量。采用 OSTHEO 公式计算围手术期失血量。记录术后第 1、3、5 天的失血量。通过从总失血量中减去术中失血量来确定隐性失血量（HBL）。
结果
本研究共纳入 263 例患者，其中 85 例接受 SuperPath 治疗，178 例接受 PLTH 治疗。两组患者的人口统计学数据、诊断、患侧、手术时间和术前血红蛋白浓度无显著差异（均 P > 0.05）。与 PLTH 组相比，SuperPath 组的术中失血量、术后第 1、3、5 天的失血量以及 HBL 均显著减少（均 P < 0.05）。SuperPath 组的总失血量和 HBL 分别为 790.07 ± 233.37 和 560.67 ± 195.54 mL，PLTH 组分别为 1141.26 ± 482.52 和 783.45 ± 379.24 mL。PLTH 组术后红细胞压积下降幅度显著大于 SuperPath 组（P < 0.001）。SuperPath 组的输血率（P = 0.028）和输血量（P = 0.019）也显著低于 PLTH 组。
结论
与传统 PLTH 相比，SuperPath 可减少围手术期失血量和输血率。
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