双侧同时初次人工全髋关节置换术显性失血和隐性失血的分析

目的探讨双侧同时行初次人工全髋关节置换术患者的显性和隐性失血情况及处理对策。方法对2008年1月—2011年1月收治的48例患者术前、术后血常规及术中、术后出血、输血情况进行回顾性分析,对患者围术期隐性出血情况进行评估。结果本组48例全部进行术中自体血回输,术中出血量（791±155）ml,术后引流量（181±57）ml,全部病例均另予输红细胞悬液及血浆,输红细胞悬液量（800±425）ml。本组总失血量（2 532±341）ml,隐性失血量（1 521±116）ml,隐性失血量占总失血量的62.5%。结论进行双侧初次人工全髋关节置换手术应重视隐性失血量,及时采取相应的处理措施充分有效地恢复患者有效循环血量,以保证安全渡过围术期及患者的康复。

Analysis of obvious and hidden blood loss during treatment of bilateral primary total hip arthroplasty

Objective To analyze the obvious and hidden blood loss during treatment of the bilateral primary total hip arthroplasty and put forward the treatment measures. Methods The postoperative blood routine,perioperative,postoperative blood loss and transfusion and hidden blood loss of bilateral primary total hip arthroplasty which were performed in 48 patients from January 2008 to January 2011 were analyzed retrospectively and evaluated. Results 48 cases were performed with intraoperative autologous blood transfusion.Blood loss during operation was（791±155） ml and postoperative drainage volume was（181±57）ml.All patients were received blood transfusion to raise the level of HGB（Hemoglobin） and CRCS transfusion was（800±425）ml.Total blood loss was（2 532±341）ml,hidden blood loss was（1 521±116）ml,hidden blood loss in total blood loss percentage was 62.5%. Conclusion Hidden blood loss is an important factor which affect the prognosis of patients on unilateral primary total hip replacement surgery and the hidden blood loss should be fully considered in such an operation evaluation to take the corresponding treatment measures fully effectively recover the patients effective circulation blood volume.In this way,can we ensure that the perioperative security and the recovery of patients.