Objective Identification of the risk factors for extraordinary hidden blood loss(HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in s...Objective Identification of the risk factors for extraordinary hidden blood loss(HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in spinal surgery.Methods Medical records were retrospectively retrieved to collect the data of patients who undergoing posterior thoracic and lumbar fusion surgery or scoliosis surgery. Demographic information, perioperative visible blood loss volume, as well as laboratory results were recorded. The patients receiving fusion surgery or scoliosis surgery were further divided into the HBL positive subgroup and the HBL negative subgroup. Differences in the variables between the groups were then analyzed. Binary logistic regression analysis was performed to determine independent risk factors associated with HBL.Results For patients undergoing posterior spinal surgery, the independent risk factors associated with HBL were autologous transfusion(for fusion surgery P = 0.011, OR: 2.627, 95%CI: 1.574-2.782; for scoliosis surgery P < 0.001, OR: 2.268, 95%CI: 2.143-2.504) and allogeneic transfusion(for fusion surgery P < 0.001, OR: 6.487, 95%CI: 2.349-17.915; for scoliosis surgery P < 0.001, OR: 3.636, 95%CI: 2.389-5.231).Conclusion Intraoperative blood transfusion might be an early-warning indicator for perioperative HBL.展开更多
人工全髋关节置换术(total hip arthroplasty,THA)和人工全膝关节置换术(total knee arthroplasty,TKA)的患者在术后常存在严重的隐性失血,通常导致患者下床行走的时间推迟,功能恢复缓慢,严重影响临床疗效。隐性失血量可以根据Gross方...人工全髋关节置换术(total hip arthroplasty,THA)和人工全膝关节置换术(total knee arthroplasty,TKA)的患者在术后常存在严重的隐性失血,通常导致患者下床行走的时间推迟,功能恢复缓慢,严重影响临床疗效。隐性失血量可以根据Gross方程来计算,虽然在髋、膝关节置换术后预防贫血减少异体输血量的治疗方面已经取得了很多经验,但隐性失血的真实机制尚未明确。对隐性失血机制的正确研究有助于提高临床评估能力,可帮助关节置换患者顺利度过围手术期,有利于术后早期开展关节功能锻炼。文中就人工关节置换术后的隐性失血的机制及治疗方面进行分析,为今后的临床治疗及研究奠定基础。展开更多
目的:探讨急诊行股骨近端髓内钉(PFN)治疗老年患者股骨转子间骨折的隐性失血量及其对治疗的影响。方法:根据纳入标准,总结2011年1月-2013年1月行PFN内固定治疗的高龄骨质疏松性转子间骨折28例。计算患者的隐性失血量。所有病例均经牵引...目的:探讨急诊行股骨近端髓内钉(PFN)治疗老年患者股骨转子间骨折的隐性失血量及其对治疗的影响。方法:根据纳入标准,总结2011年1月-2013年1月行PFN内固定治疗的高龄骨质疏松性转子间骨折28例。计算患者的隐性失血量。所有病例均经牵引床牵引、闭合复位,术中不显露骨折区域,小切口置入PFN。结果:所有患者平均隐性失血量811 m L,显性失血量92 m L,平均失血总量为903 m L。隐性失血和显性失血占失血总量的比例分别为89.8%和10.2%,隐性失血量远多于显性失血量。不同性别组间以及肥胖组与非肥胖组间的隐性失血量比较,差异无统计学意义。结论:隐性失血是高龄股骨转子间骨折手术围术期失血的主要原因,应及时补充血容量。性别和肥胖不是隐性失血的危险因素。展开更多
文摘Objective Identification of the risk factors for extraordinary hidden blood loss(HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in spinal surgery.Methods Medical records were retrospectively retrieved to collect the data of patients who undergoing posterior thoracic and lumbar fusion surgery or scoliosis surgery. Demographic information, perioperative visible blood loss volume, as well as laboratory results were recorded. The patients receiving fusion surgery or scoliosis surgery were further divided into the HBL positive subgroup and the HBL negative subgroup. Differences in the variables between the groups were then analyzed. Binary logistic regression analysis was performed to determine independent risk factors associated with HBL.Results For patients undergoing posterior spinal surgery, the independent risk factors associated with HBL were autologous transfusion(for fusion surgery P = 0.011, OR: 2.627, 95%CI: 1.574-2.782; for scoliosis surgery P < 0.001, OR: 2.268, 95%CI: 2.143-2.504) and allogeneic transfusion(for fusion surgery P < 0.001, OR: 6.487, 95%CI: 2.349-17.915; for scoliosis surgery P < 0.001, OR: 3.636, 95%CI: 2.389-5.231).Conclusion Intraoperative blood transfusion might be an early-warning indicator for perioperative HBL.
文摘人工全髋关节置换术(total hip arthroplasty,THA)和人工全膝关节置换术(total knee arthroplasty,TKA)的患者在术后常存在严重的隐性失血,通常导致患者下床行走的时间推迟,功能恢复缓慢,严重影响临床疗效。隐性失血量可以根据Gross方程来计算,虽然在髋、膝关节置换术后预防贫血减少异体输血量的治疗方面已经取得了很多经验,但隐性失血的真实机制尚未明确。对隐性失血机制的正确研究有助于提高临床评估能力,可帮助关节置换患者顺利度过围手术期,有利于术后早期开展关节功能锻炼。文中就人工关节置换术后的隐性失血的机制及治疗方面进行分析,为今后的临床治疗及研究奠定基础。
文摘目的:探讨急诊行股骨近端髓内钉(PFN)治疗老年患者股骨转子间骨折的隐性失血量及其对治疗的影响。方法:根据纳入标准,总结2011年1月-2013年1月行PFN内固定治疗的高龄骨质疏松性转子间骨折28例。计算患者的隐性失血量。所有病例均经牵引床牵引、闭合复位,术中不显露骨折区域,小切口置入PFN。结果:所有患者平均隐性失血量811 m L,显性失血量92 m L,平均失血总量为903 m L。隐性失血和显性失血占失血总量的比例分别为89.8%和10.2%,隐性失血量远多于显性失血量。不同性别组间以及肥胖组与非肥胖组间的隐性失血量比较,差异无统计学意义。结论:隐性失血是高龄股骨转子间骨折手术围术期失血的主要原因,应及时补充血容量。性别和肥胖不是隐性失血的危险因素。
