【摘要】 目的:分析围手术期全程血液管理对膝关节置换术患者失血、术后并发症及经济费用的影响。方法:随机数字法将行膝关节置换术的60例患者分为观察组与对照组,各30例,观察组实施围术期全程血液管理,对照组则行常规血液管理,对两组手术指标、输血情况、术后并发症、住院时间及经济费用比较,并测定比较两组围术期血红蛋白(Hb)、红细胞压积(HCT)及凝血指标变化情况。结果:观察组引流量、隐性失血量、住院总费用均显著少于对照组,住院时间显著短于对照组,差异有统计学意义;两组术后3d Hb、HCT比术前均显著下降,但观察组术后3d Hb、HCT显著高于对照组;两组凝血4项指标比较差异无统计学意义;观察组术后异体输血率3.33%,贫血发生率13.33%,比对照组的26.67%、36.67%差异有统计学意义。结论:围术期全程血液管理能显著减少膝关节置换术患者隐性出血量,降低贫血发生率,且对机体凝血功能无影响,同时能显著缩短住院时间、减少住院总费用,临床及经济效益好。更多还原

【Abstract】 Objective To analyze the effect of perioperative whole-course blood management on blood loss, postoperative complications and economic costs of patients undergoing knee replacement. Methods 60 cases of patients undergoing knee replacement were randomly divided into the observation group and the control group by random number table method, 30 cases in each group. The observation group was given perioperative whole-course blood management, while the control group was given routine blood management. The operation parameters, blood transfusion, postoperative complications, hospital stay and economic costs were compared between the two groups. The changes of hemoglobin(Hb), hematocrit(HCT) and coagulation indexes were compared between the two groups. Results The drainage volume, hidden blood loss and total hospitalization costs of the observation group were significantly less than those in the control group, and the hospitalization time was significantly shorter than that of the control group.3 days after operation, Hb and HCT in the two groups were significantly decreased, and those in the observation group were significantly higher than those in the control group. There were no significant differences in four items of blood coagulation indexes between the two groups. After operation, the rate of allogeneic transfusion and the incidence of anemia showed significant differences between the observation group and the control group(3.33% and 13.33% vs 26.67% and36.67%). Conclusion Perioperative whole-course blood management can significantly reduce the hidden blood loss and the incidence of anemia in patients undergoing knee replacement. It has no effect on blood coagulation function, and can significantly shorten the hospitalization time and reduce the total hospitalization costs, and its clinical and economic benefit is good.更多还原