【摘要】 目的:探讨老龄人全髋膝关节置换术失血量的及时评估和处理。方法:回顾性调查了46例年龄大于60岁的全膝关节置换术(TKA)和146例全髋关节置换术(THA)的老龄患者术中、术后失血量、术后处理及恢复情况。结果:<70岁组THA总失血量平均为1425mL,隐性失血量为729mL(51%);TKA总失血量为1386mL,隐性失血量为890mL(64%)。≥70岁组THA总失血量平均为1435mL,其中隐性失血量769mL(53%);TKA术总失血量平均1380mL,隐性失血量910mL(65%)。TKA组隐性失血量均大于THA组(P<0.05)。THA组内隐性失血量比较年龄是重要影响因素(P<0.05),而TKA组内没有区别(P>0.05)。结论:老年人对失血耐受性差,全髋膝关节置换术失血量应正确评估,隐性失血占的比例大,及时处理失血性贫血有利于机体的早日康复。更多还原

【Abstract】 ObjectiveTo analyze the evaluation and treatment of blood loss during total hip arthroplasty(THA )and total knee arthroplasty(TKA) in the aged . MethodsWe retrospectively surveyed the blood loss and the rehabilitation of 46 cases of TKA and 146 cases of THA older than 60. ResultsIn the group younger than 70,the mean total blood loss of THA was 1425 mL and the hidden hemorrhage 729mL (51%); following the TKA,the mean total loss was 1386 mL and the hidden hemorhage was 890mL (64%). In the group 70 and older, the mean total blood loss of THA was 1435mL and the hidden hemorhage was 769mL (53%); following the TKA,the mean total loss was 1380mL and the hidden hemorhage was 910mL (65%). The difierence of hidden hemorhage between the THA and the TKA was both significant by different (P<0.05). Age played an important part in the THA group(P<0.05), but not in the TKA group(P>0.05). ConclusionThe aged have poor resistance to blood loss. Hidden hemorrhage in the TKA or THA perhaps is the primary part of the blood loss. Prompt treatment is helpful for the rehabilitation.更多还原