协和医学杂志Issue(2)：135-141,7.DOI:10.3969/j.issn.1674-9081.2014.02.002
全膝关节置换术围手术期异体输血率及其影响因素
Allogeneic Transfusion Rate and Related Factors in Primary Total Knee Arthroplasty
摘要
Abstract
Objective To evaluate the transfusion rates and identify perioperative factors associated with allogeneic blood transfusion ( AllTx) after primary total knee arthroplasty ( TKA) with routine use of low-molecu-lar-weight heparins .Methods We retrospectively studied the transfusion rate of 1165 consecutive patients who underwent primary TKA between January 2005 and December 2011 .Totally 34 independent variables were ana-lyzed in 617 primary unilateral TKAs without autologous blood predonation for requirement of AllTx .Multiple re-gression analysis model was used to identify risk factors associated with perioperative blood transfusion .Results Overall, 58.2% (678/1165 ) of patients required AllTx .The median number of units transfused was 2.7 U ( range:1 to 13 U).The AllTx rate was 40.0%(278/695) in unilateral TKA procedures and 85.1%(400/470) in one-stage bilateral TKA procedures .Univariate analysis demonstrated the risk of transfusion was independently predicted by the patients'age at surgery ( P<0.0001 ) , preoperative hematocrit ( P<0.0001 ) , preoperative he-moglobin concentration (P<0.0001), American Society of Anesthesiologists (ASA) score ≥3 (P=0.004), surgical time ( P=0.004 ) , and tourniquet time ( P=0.050 ) .Multivariate Logistic regression analysis confirmed significant relationship between allogeneic blood transfusion and age ( P <0.0001 ) , preoperative hemoglobin ( P<0.0001 ) , and surgical time ( P<0.0001 ) .Conclusions AllTx rate is high in TKA procedures , especial-ly in one-stage bilateral TKA procedures .Patient's age, preoperative hemoglobin level , and surgical time are helpful in identifying high-risk patients who require postoperative blood transfusion .关键词
膝关节/关节成形术/围手术期/异体输血/影响因素Key words
knee joint/arthroplasty/perioperation/allogeneic transfusion/influencing factor分类
医药卫生引用本文复制引用
彭慧明,翁习生,翟吉良,林进,金今,钱文伟,赵丽娟..全膝关节置换术围手术期异体输血率及其影响因素[J].协和医学杂志,2014,(2):135-141,7.基金项目
卫生部部属（管）医疗机构临床学科重点项目建设专项资金 （）
