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术前自体血捐献及术中术后血液回收对非骨水泥型全髋关节置换术同种异体输血需求的影响。

Effect of preoperative autologous blood donation and intraoperative and postoperative blood recovery on homologous blood transfusion requirement in cementless total hip replacement operation.

作者信息

Huo M H, Paly W L, Keggi K J

机构信息

Department of Orthopaedic Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.

出版信息

J Am Coll Surg. 1995 May;180(5):561-7.

PMID:7749531
Abstract

BACKGROUND

Blood transfusion is often necessary in operations for total hip replacement (THR). This study was done to investigate the efficacy of three different methods of autologous blood conservation and transfusion in patients undergoing primary THR without cement.

STUDY DESIGN

One hundred fifty-five patients with osteoarthritis underwent unilateral cementless THR using normotensive general anesthesia performed by a single surgeon. The patients were divided into four groups depending on which conservation method was used. Ten different demographic and hematologic parameters were recorded and analyzed by using analysis of the variance and multiple regression methods.

RESULTS

All three methods were effective in reducing the need for homologous blood transfusions. The greatest benefit was realized when both preoperative autologous blood donation and intraoperative salvage using the Cell Saver were combined. The addition of postoperative salvage and retransfusion of wound drainage blood using the Solcotrans System did not significantly reduce further the chance of homologous blood transfusions.

CONCLUSIONS

The data from this study were similar to previously published reports. Regression analysis confirmed the correlation among the different variables studied. We currently offer preoperative donation and intraoperative salvage with the Cell Saver to patients undergoing cementless total hip replacement.

摘要

背景

全髋关节置换术(THR)手术中常需要输血。本研究旨在调查三种不同自体血保存和输血方法对初次非骨水泥型THR患者的疗效。

研究设计

155例骨关节炎患者由一名外科医生采用降压全身麻醉进行单侧非骨水泥型THR。根据所采用的保存方法将患者分为四组。记录10项不同的人口统计学和血液学参数,并采用方差分析和多元回归方法进行分析。

结果

所有三种方法在减少异体输血需求方面均有效。术前自体血捐献和术中使用血液回收机进行血液回收相结合时获益最大。使用索科输血系统进行术后伤口引流血回收和回输并不能进一步显著降低异体输血的几率。

结论

本研究数据与先前发表的报告相似。回归分析证实了所研究的不同变量之间的相关性。我们目前为接受非骨水泥型全髋关节置换术的患者提供术前献血和术中使用血液回收机进行血液回收。

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