双极人工股骨头置换患者术后隐形失血的研究

摘要

Objective To evaluate the postoperative invisible blood loss in patients with bipolar artificial femoral head replacement surgery. Methods The clinical data of 62 patients with bipolar artificial femoral head re-placement surgery admitted in our hospital from January 2006 to June 2013 were analyzed. The volume of postopera-tive invisible blood loss, changes in perioperative Hct and variation of invisible blood loss in patients with different age, sex, body mass index (BMI), with or without preoperative chronic diseases, with or without postoperative ve-nous thrombosis in lower limbs and different postoperative anticoagulation protocols were observed and documented. Results The postoperative invisible blood loss was (560.82 ± 89.16) ml, accounting for 62.22% of the total blood loss. 2 days after operation, the Hct reached a minimum value, and it increased steadily in the 3rd postoperative day. The postoperative blood loss volume in patients with BMI>25 kg/m2 was more than those with BMI≤25 kg/m2, and the difference was statistically significant (P<0.05). There was no difference between patients with different age, sex, with or without preoperative patients disease, with or without postoperative thrombosis in lower limbs and different postoperative anticoagulation protocols (P>0.05). Conclusion The postoperative invisible blood loss plays an impor-tant role in prognosis, which is mainly influenced by BMI.%目的：评价初次进行双极人工股骨头置换术患者的隐性失血状况。方法选取2006年1月至2013年6月在我院进行双极人工股骨头置换术的62例患者的临床资料，观察并统计患者术后隐性出血量、围术期血细胞比容(Hct)的变化以及评估在不同年龄、性别、体质量指数、术前是否合并慢性疾病、术后是否下肢静脉血栓及术后抗凝方式患者围术期的隐性出血情况。结果患者术后隐性失血量为(560.82±89.16) ml，占总失血量的62.22%；术后第2天是患者Hct的最低值，在术后第3天以后患者的Hct呈现出平稳上升趋势；患者体质量指数>25 kg/m2的术后隐性失血量明显多于≤25 kg/m2者，差异有统计学意义（P<0.05）；而年龄、性别、术前是否合并慢性疾病、术后是否下肢静脉血栓及术后抗凝方式的差异对于隐性失血量的影响差异无统计学意义(P>0.05)。结论隐性失血是影响患者预后的重要因素，体质量指数对患者隐性失血的影响较大。