[使用血液回收系统与传统引流系统的全膝关节假体失血量变化]。

Acta ortopedica mexicana Pub Date : 2023-07-01
G Pedemonte-Parramón, D Rodríguez-Montserrat, F Aliaga-Orduña, E García-Oltra, J A Hernández-Hermoso
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引用次数: 0

摘要

导言:膝关节假体手术可能会导致大量失血,最多可占血容量的 20%。我们的研究旨在分析全膝关节置换术(TKR)后,使用血液回收系统与普通引流管的失血量(BL)。我们分析了术后 3、24、48、72 和 96 小时的 PS、血红蛋白 (Hb)、血细胞比容 (Htc)、收缩压 (SBP)、舒张压 (DBP) 和心率 (HR)、输血需求、72 小时内出院比例和并发症。结果:Htc 和 Hb 变化的最高百分比发生在术后最初 3 小时,RG 在 72 小时开始恢复(p = 0.02),CG 在 96 小时开始恢复(p = 0.04)。RG 和 CG 的 Hb 和 Htc 分别在术后 72 小时和 96 小时开始下降。两组的 TAS、TAD 和 FC 均在 72 小时开始恢复。手术后 3 小时(p = 0.02)、24 小时(p = 0.02)和 48 小时(p = 0.01),CG 的 SBP 下降幅度更大。RG 有 6 名患者输血,CG 有 10 名患者输血(p = 0.22)。CG和RG中分别有20%和74%的患者在72小时后出院。结论:最大的BL发生在术后的前3小时,72-96小时开始恢复。恢复期血液系统可降低术后前 3 小时的血红蛋白浓度,促进血红蛋白和血压的恢复,减少输血需求,有利于患者尽早出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Evolution of blood loss in total knee prosthesis with blood recovery system vs conventional drainage].

Introduction: knee prosthetic surgery can be associated with significant blood loss that can account for up to 20% of blood volume. The objective of our study is to analyze blood loss (BL) after total knee replacement (TKR), with the use of a blood recovery system vs a normal drain.

Material and methods: prospective, comparative, and observational study of two groups of 30 patients who underwent TKR, one control (CG) and another study group with a recovery system (RG). We analyzed PS, hemoglobin (Hb), hematocrit (Htc), systolic blood pressure (SBP) and diastolic blood pressure (DBP) and heart rate (HR) at 3-, 24-, 48-, 72- and 96-hours post-surgery, the need for transfusion, and the percentage of discharges in 72 hours and complications.

Results: the highest percentage of change in Htc and Hb occurred in the first 3 hours post-surgery and recovery began at 72 hours in the RG (p = 0.02) and at 96 hours in the CG (p = 0.04). The decrease in Hb and Htc began his recovery at 72 hours in the RG and at 96 hours in the CG. The TAS, TAD and FC began their recovery at 72 hours in both groups. The decrease in SBP was greater in the CG at 3 hours (p = 0.02), 24 hours (p = 0.02) and 48 hours (p = 0.01) post-surgery. Six patients were transfused in RG and 10 in CG (p = 0.22). 20% and 74% of the patients were discharged at 72 hours in the CG and RG, respectively.

Conclusion: the greatest BL occurs in the first 3 hours post-surgery and recovery begins at 72-96 hours. Recovery blood system decreases BL during the first 3 hours, enhance the recuperation of Hb and SBP, decreases the need for transfusion and favors early discharge.

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