初次全膝关节置换术后肢体肿胀程度与隐性失血量的相关性研究

[目的]膝关节置换术后下肢肢体肿胀是术后常见现象,隐性失血为其可能的原因之一.本研究旨在分析初次全膝关节置换术后隐性失血对肢体肿胀程度的影响.[方法]对2007年10月～2009年8月接受全膝关节置换术的286例患者进行回顾性分析,按照术后有无下肢深静脉血栓形成分为血栓组(65例)和无血栓组(221例),通过围手术期血红蛋白变化值来推算隐性失血量(Hbl),还计算出术后第2～5 d的术侧下肢膝上10 cm及膝下10 cm周径较术前相比周径增加的平均值D-up及D-down.[结果]在无血栓组,隐性失血量对术侧下肢膝上膝下肢体周径变化均造成影响,具有统计学意义(P＜0.001),分别建立线性回归方程,在血栓组,隐性失血量对术侧下肢膝上膝下肢体周径变化影响不大,两者Pearson相关分析不具有统汁学意义(P=0.110,P=0.066),有无血栓组间经两独立样本t检验,发现两组间D-up、D-down和Hhl的差异均没有统计学意义,P值分别为0.334,0.156,0.180.[结论]初次全膝关节置换术后,特别是3～5 d内,应持续关注患者血色素的变化,隐性失血量与下肢的肿胀程度呈相关性,在一定程度上形成并加重了肢体肿胀.TKA术后下肢肌间静脉丛血栓形成对远端肢体肿胀程度影响不大,考虑后者主要还是与隐性失血有关.

Correlation of limb swelling with hidden blood loss after primary total knee arthroplasty

[Objective]Lower extremity swelling is a common phenomenon after knee replacement surgery,hidden blood loss may be one of the reasons.This study aimed to analyze the hidden blood loss after initial total knee arthroplasty on the degree of limb swelling. [Methods]Totally 286 patients undergoing total knee arthroplasty surgery from October 2007 to August 2009 were retrospectively analyzed.In accordance with the existence of DVT,the patients were divided into thrombosis group(n=65) and non-thrombosis group(n=2...