Yangzhou Clinical Medical College of Nanjing Medical University, Yangzhou, Jiangsu, China.
Medicine (Baltimore). 2023 Sep 29;102(39):e35512. doi: 10.1097/MD.0000000000035512.
The present study aims to validate the methods of quantifying blood loss in arthroscopic rotator cuff repair and to investigate the correlation between blood loss and joint pain and joint function recovery. A total of 38 patients with unilateral rotator cuff injuries who underwent shoulder arthroscopy were analyzed in this study. Related information, including age, gender, blood pressure, body mass index (BMI), disease entity, comorbidity, joint release, and operating time, were collected into a spreadsheet. Serum hemoglobin and hematocrit (HCT) levels were obtained before the surgery and on the first and third days after the operation. The visual analog scale (VAS) score and the constant-Murley score of the shoulder joint were evaluated 1 year after the operation. Preoperative blood volume (PBV), red blood cell (RBC), hemoglobin (Hb), and HCT levels were significantly higher than those on postoperative day 1 and day 3. The average surgery-related blood loss was calculated to be 435.2 ± 53.6 mL during the surgery and the first postoperative day and 542.5 ± 63.0 mL during the surgery and the first 3 days after the surgery. The VAS score was significantly reduced 1 year after surgery. The multivariate linear regression analysis showed that joint release was a potential risk factor for predicting blood loss 1 or 3 days postoperatively. The actual blood loss from shoulder arthroscopy may be underestimated. The joint release was regarded as the leading risk factor for blood loss.
本研究旨在验证关节镜肩袖修复术中出血量的量化方法,并探讨出血量与关节疼痛和关节功能恢复的相关性。本研究共分析了 38 例单侧肩袖损伤接受肩关节镜手术的患者。收集了相关信息,包括年龄、性别、血压、体重指数(BMI)、疾病实体、合并症、关节松解和手术时间。术前及术后第 1、3 天采集血清血红蛋白(Hb)和血细胞比容(HCT)水平。术后 1 年评估视觉模拟评分(VAS)和Constant-Murley 评分。术前血容量(PBV)、红细胞(RBC)、Hb 和 HCT 水平均明显高于术后第 1 天和第 3 天。术中及术后第 1 天的平均手术相关出血量为 435.2±53.6mL,术中及术后第 1 天和第 3 天的平均出血量为 542.5±63.0mL。术后 1 年 VAS 评分明显降低。多元线性回归分析显示,关节松解是术后 1 天或 3 天预测出血量的潜在危险因素。肩关节镜手术的实际失血量可能被低估。关节松解被认为是出血的主要危险因素。