同期双侧全膝关节置换与选择性单侧全膝关节置换的用血特点分析
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摘要
目的:调查同期双侧膝关节置换与选择性单侧膝关节置换手术的用血情况,归纳此2种手术的用血特点,为原发性膝关节病手术方案评估提供参考。方法:对近3年的4 384例人工膝关节置换术患者进行回顾性调查,对同期双侧全膝关节置换与选择性单侧全膝关节置换的用血情况进行分析,归纳总结该2种手术用血特点。结果:1 316例同期双侧全膝关节置换术患者,用血275例,人均用血量0.66U,用血患者人均用血量3.15U,用血概率20.90%,平均住院日9.19d,人均费用6.25万元;3 068例选择性单侧全膝关节置换患者,用血228例,人均用血量0.18U,用血患者人均用血量2.48U,用血概率7.43%,平均住院日8.56d,人均费用10.22万元。结论:(1)同期双侧全膝关节置换术人均用血量和用血概率显著高于选择性单侧膝关节置换术(P<0.05)。(2)原发性双侧膝关节病进行分期双侧(择期2次单侧)膝关节置换的平均住院日和平均住院费用显著高于同期双侧全膝关节置换(P<0.05)。
Objective:To investigate the blood using condition of bilateral total knee replacement and selective unilateral total knee replacement at the same time,and summarize the blood using characteristics of these two operations,so as to provide a reference for the evaluation of primary knee joint disease.Method:A retrospective investigation was conducted on 4 384 cases of artificial knee joint replacement in our hospital in the past three years(2015—2017).Blood using condition of bilateral total knee replacement and selective unilateral total knee replacement in the same period were analyzed,and the characteristics of the two types of surgical blood using characteristics were summarized.Result:There were 1 316 patients undergoing bilateral total knee replacement in the same period,with 275 cases of blood using,the blood consumption per capita was 0.66 U,the blood consumption per patient with blood was 3.15 U,probability of using blood was 20.90%,average days of hospitalization was 9.19,and the per capita cost was 62,500 yuan.There were 3 068 patients undergoing selective unilateral total knee replacement,with 228 cases of blood using,the blood consumption per capita was 0.18 U,the blood consumption per patient with blood was 2.48 U,probability of using blood was 7.43%,average days of hospitalization was 8.56 days,and the per capita cost was 102 200 yuan.Conclusion:(1)During the same period,the per capita blood consumption and probability of bilateral total knee replacement were significantly higher than those of selective unilateral total knee replacement(P<0.05).(2)The average hospitalization day and average hospitalization cost of the primary bilateral total knee replacement been divided into two stages(split up two unilateral turns)would be significantly higher than those of bilateral total knee replacement(P<0.05).
Objective:To investigate the blood using condition of bilateral total knee replacement and selective unilateral total knee replacement at the same time,and summarize the blood using characteristics of these two operations,so as to provide a reference for the evaluation of primary knee joint disease.Method:A retrospective investigation was conducted on 4 384 cases of artificial knee joint replacement in our hospital in the past three years(2015—2017).Blood using condition of bilateral total knee replacement and selective unilateral total knee replacement in the same period were analyzed,and the characteristics of the two types of surgical blood using characteristics were summarized.Result:There were 1 316 patients undergoing bilateral total knee replacement in the same period,with 275 cases of blood using,the blood consumption per capita was 0.66 U,the blood consumption per patient with blood was 3.15 U,probability of using blood was 20.90%,average days of hospitalization was 9.19,and the per capita cost was 62,500 yuan.There were 3 068 patients undergoing selective unilateral total knee replacement,with 228 cases of blood using,the blood consumption per capita was 0.18 U,the blood consumption per patient with blood was 2.48 U,probability of using blood was 7.43%,average days of hospitalization was 8.56 days,and the per capita cost was 102 200 yuan.Conclusion:(1)During the same period,the per capita blood consumption and probability of bilateral total knee replacement were significantly higher than those of selective unilateral total knee replacement(P<0.05).(2)The average hospitalization day and average hospitalization cost of the primary bilateral total knee replacement been divided into two stages(split up two unilateral turns)would be significantly higher than those of bilateral total knee replacement(P<0.05).
引文
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[4]司枫.同期与分期双侧膝关节置换的临床疗效比较[J].保健文汇,2018,8(6):55-55.
[5]王文浩,田少奇,张才龙,等.同期双侧与单侧全膝关节置换治疗膝骨关节炎的比较[J].中国矫形外科杂志,2012,20(7):598-602.
[6]段东东,胡锐,黄平,等.局部应用氨甲环酸对减少全膝关节置换术后失血量及输血率的疗效[J].临床骨科杂志,2017,20(1):61-63.
[7] Hunter DJ,Felson DT.osteoarthritis[J].BMJ,2006:332:639-642.
[8]迟少毅,董乐乐,曹兴茹.雌激素及其受体与骨性关节炎的相关性研究进展[J].中国妇幼保健,2018,33(8):1918-1920.
[9] Wluka AE,Cicuttini FM,Spector TD.Menopause,oestrogens and arthritis[J].Maturitas,2000,35:183-199.
[10]Gilliss BM,Looney MR,Gropper MA.Reducing noninfectious risks of blood transfusion[J].Anesthesiology,2011,115:635-649.
[2]王超,孙天胜,朱兵.同期双侧膝关节置换术的安全性及疗效研究[J].临床和实验医学杂志,2011,10(9):672-673,675.
[3]朱斌杰,陈哲峰,刘锋,等.同期和分期全膝关节置换术治疗双膝关节骨关节炎的安全性与疗效[J].中华骨科杂志,2014,34(6):619-623.
[4]司枫.同期与分期双侧膝关节置换的临床疗效比较[J].保健文汇,2018,8(6):55-55.
[5]王文浩,田少奇,张才龙,等.同期双侧与单侧全膝关节置换治疗膝骨关节炎的比较[J].中国矫形外科杂志,2012,20(7):598-602.
[6]段东东,胡锐,黄平,等.局部应用氨甲环酸对减少全膝关节置换术后失血量及输血率的疗效[J].临床骨科杂志,2017,20(1):61-63.
[7] Hunter DJ,Felson DT.osteoarthritis[J].BMJ,2006:332:639-642.
[8]迟少毅,董乐乐,曹兴茹.雌激素及其受体与骨性关节炎的相关性研究进展[J].中国妇幼保健,2018,33(8):1918-1920.
[9] Wluka AE,Cicuttini FM,Spector TD.Menopause,oestrogens and arthritis[J].Maturitas,2000,35:183-199.
[10]Gilliss BM,Looney MR,Gropper MA.Reducing noninfectious risks of blood transfusion[J].Anesthesiology,2011,115:635-649.