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自体输血在人工关节置换术的应用 |
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吕厚山 寇伯龙 高彤 袁燕林 关振鹏
【摘要】目的 人工髋、膝关节置换术后出血量较大，尤其是膝关节置换术后平均引流量达600～800ml，常需输血治疗。而异体输血可引起许多不良反应和并发症，因此自体输血技术日益受到重视。本文介绍自体输血的初步经验。方法 自1991年起，我院骨关节科共对433例施行人工髋、膝关节置换术的患者采用了自体输血技术，主要方法包括术前预存自体血和术后引流血回输技术。结果 单纯依靠术前预存自体血输血组，术后约有69％（258/374）的患者无需异体输血而顺利渡过围手术期，其中93.4％（241/258）为单侧关节置换患者，6.6％（17/258）为双膝、双髋或单侧膝髋同时置换的患者；而在单纯术后引流血回输组和两种方法结合组，这一比例则分别为36％(5/14)和75.6％（34/45）。结论 采用术前预存自体血加术后引流血回输的方法，可使多数施行人工髋、膝关节置换术的病例避免了异体输血及由此带来的潜在危险。
【关键词】输血，自体 人工关节 膝关节
Autologous Blood Transfusion Used in Knee and Hip Arthroplasties
Houshan, KOU Bolong , GAO Tong, et al.
Arthritis ＆ Clinic Research Center,People’s Hospital of Beijing Medical Univercity ,Beijing 100044
【Abstract】 Objective Blood transfusion is often needed in knee and hip replacements. Autologous blood transfusion is now being widely used because of the complications and untoward reactions of allogenic blood transfusion.Methods Since 1991, 433 patients undergoing knee or hip arthroplasties in this centre have received autologous blood transfusion . The patients can be divided into three groups: The first group had preoperative storage and transfusion of autologous blood during the operation. The second group had reinfusion of shed blood after arthroplasty, and third had both. Results In the group of preoperative storage and auto－donation , 69％ of the patients(258/374) passed perioperative period successfully without allogenic blood transfusion, including 93.4％ (241/258) unilateral and 6.6％ (17/258) bilateral or ipsilateral arthroplasties. While in the other two groups, the results were 36％ (5/14) and 75.6％ (34/45)respectively. Conclusions Preoperative selfdonation together with reinfusion of autologous shed blood can avoid the danger of allogenic blood transfusion in the majority of arthroplasty cases.
【Key words】 Blood transfusion,autologous Joint prosthesis Knee joint
人工髋、膝关节置换术是出血量较大的手术，特别是返修术病例，术中出血量可多达1000ml以上，因此输血已成为人[1] [2] 下一页
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