髋关节重建术后隐性失血及其危险因素分析

Hidden blood loss and its risk factors after hip reconstruction in children.

机构信息

School of Clinical Medicine, Guizhou Medical University, Guiyang, China.

Department of Pediatric Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China.

出版信息

J Orthop Surg Res. 2024 Jul 5;19(1):391. doi: 10.1186/s13018-024-04861-2.

Abstract

OBJECTIVE

There were few reports in the literature regarding hidden blood loss following surgery for developmental dysplasia of the hip in children. This study aimed to evaluate the volume of hidden blood loss and its risk factors among children undergoing hip reconstruction for developmental dysplasia of the hip.

METHODS

A retrospective analysis of clinical data from 42 patients (58 hips), who underwent Pemberton and femoral osteotomies between March 2020 and March 2023, was conducted. Serial complete blood count assays were conducted on the day of admission and four days post-surgery. Preoperative and postoperative hematocrit levels were documented to calculate hidden blood loss utilizing the Gross formula. Pearson and Spearman correlation analyses, along with multivariable linear regression, were employed to ascertain associations between patient characteristics and hidden blood loss.

RESULTS

The mean hidden blood loss was recorded as 283.06 ± 271.05 mL, constituting 70.22% of the total blood loss. Multiple linear regression analysis identified weight and surgical duration as independent risk factors contributing to hidden blood loss.

CONCLUSIONS

A relevant amount of postoperative hidden blood loss occurs after Pemberton osteotomy and femoral osteotomy for developmental dysplasia of the hip. Surgeons should be aware that patients who require blood transfusions and have longer surgical durations are at a higher risk of developing more hidden blood loss. Therefore, attention should be given to hidden blood loss to ensure patient safety during the perioperative period for those undergoing Pemberton and femoral osteotomies.

LEVEL OF EVIDENCE

IV.

摘要

目的

儿童发育性髋关节发育不良行髋关节重建术后隐性失血的文献报道较少。本研究旨在评估儿童发育性髋关节发育不良行 Pemberton 髋臼成形术和股骨截骨术的隐性失血量及其危险因素。

方法

回顾性分析 2020 年 3 月至 2023 年 3 月期间行 Pemberton 髋臼成形术和股骨截骨术的 42 例(58 髋)患儿的临床资料。入院当天及术后 4 天行全血细胞计数检测,记录术前和术后血细胞比容,采用 Gross 公式计算隐性失血量。采用 Pearson 和 Spearman 相关分析及多变量线性回归分析患者特征与隐性失血量的关系。

结果

平均隐性失血量为 283.06 ± 271.05ml,占总失血量的 70.22%。多元线性回归分析显示,体重和手术时间是隐性失血量的独立危险因素。

结论

发育性髋关节发育不良行 Pemberton 髋臼成形术和股骨截骨术后会发生大量的术后隐性失血。术者应注意到需要输血和手术时间较长的患者发生更多隐性失血的风险更高。因此,在围手术期应注意隐性失血,以确保接受 Pemberton 髋臼成形术和股骨截骨术的患者的安全。

证据等级

IV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f75f/11225192/ec9f498785d5/13018_2024_4861_Fig1_HTML.jpg

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