本文選題：全膝關(guān)節(jié)置換術(shù) + 圍手術(shù)期失血量　； 參考：《山東中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的:通過臨床病例的觀察,研究全膝關(guān)節(jié)置換術(shù)的圍手術(shù)期出血量的臨床相關(guān)性因素。方法:對山東中醫(yī)藥大學(xué)附屬醫(yī)院(山東省中醫(yī)院)關(guān)節(jié)骨科2013.05-2015.01同一組醫(yī)師完成的全膝關(guān)節(jié)置換術(shù)的患者48例(50膝)進行回顧、總結(jié)、分析,記錄其各項相關(guān)性因素,包括身高、體重、體重指數(shù),是否合并內(nèi)科基礎(chǔ)疾病,影像學(xué)分級,假體類型、手術(shù)入路等,根據(jù)患者自身體重、身高以及術(shù)前術(shù)后血液檢驗數(shù)據(jù)患者計算圍手術(shù)期失血量,根據(jù)統(tǒng)計學(xué)分析,研究其臨床相關(guān)性。結(jié)果:48例(50膝)病人均手術(shù)順利,術(shù)后恢復(fù)良好,切口均I/甲級愈合,未出現(xiàn)感染、脫位、假體周圍骨折等現(xiàn)象。48例(50膝)全膝關(guān)節(jié)置換圍手術(shù)期總失血量波動在平均為652.58±102.70ml。所有病例均輸注懸浮紅細(xì)胞2u((1 U=200 mL全血容量),臨床資料證明,年齡、體重指數(shù),是否合并內(nèi)科基礎(chǔ)疾病,影像學(xué)分級,膝關(guān)節(jié)置換假體類型在全膝關(guān)節(jié)置換術(shù)圍手術(shù)期失血量方面差異有統(tǒng)計學(xué)意義,表明患者年齡在70歲以上,體重指數(shù)大于30Kg/m2,合并內(nèi)科基礎(chǔ)疾病,影像學(xué)分級等級越高,術(shù)中應(yīng)用后交叉韌帶切除型-PS假體等因素導(dǎo)致了圍手術(shù)期失血量的增加,而手術(shù)入路在全膝關(guān)節(jié)置換術(shù)圍手術(shù)期失血量方面差異無統(tǒng)計學(xué)意義。結(jié)論:年齡、體重指數(shù),是否合并內(nèi)科基礎(chǔ)疾病,影像學(xué)分級及全膝關(guān)節(jié)置換術(shù)假體類型均與全膝關(guān)節(jié)置換術(shù)圍手術(shù)期失血量存在相關(guān)性。
[Abstract]:Objective: to study the clinical correlation factors of perioperative bleeding in total knee arthroplasty (TKA). Methods: 48 cases (50 knees) of total knee arthroplasty performed by the same group of physicians in the Department of Joint Orthopaedics, Shandong University of traditional Chinese Medicine (Shandong Provincial Hospital of traditional Chinese Medicine) were reviewed, analyzed and recorded. They include height, weight, body mass index, whether or not they are associated with basic internal diseases, imaging classification, prosthesis type, surgical approach, etc. The perioperative blood loss is calculated according to the patient's own weight, height and blood test data before and after surgery. According to statistical analysis, the clinical correlation was studied. Results the operation was successful in 48 cases with 50 knees. The postoperative recovery was good. All the incisions healed without infection, dislocation and fracture around the prosthesis. The total blood loss fluctuated in the average of 652.58 鹵102.70 ml during the perioperative period of total knee arthroplasty. All patients were infused with 200 mL whole blood volume of suspended red blood cell (2u((1). The clinical data showed that age, body mass index (BMI), whether the patients were complicated with basic diseases of internal medicine, imaging grade, or not. The type of knee arthroplasty prosthesis was significantly different in perioperative blood loss after total knee arthroplasty, indicating that the patients were over 70 years old, had a body mass index (BMI) of more than 30 kg / m ~ (2), complicated with basic diseases of internal medicine, and the higher the grade of imaging grade was. The application of posterior cruciate ligament resected prosthesis and other factors resulted in the increase of blood loss in perioperative period, but there was no significant difference between operative approach and perioperative blood loss in total knee arthroplasty. Conclusion: age, body mass index (BMI), basic medical diseases, imaging grade and prosthesis type of total knee arthroplasty are correlated with perioperative blood loss of total knee arthroplasty.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.4

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