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中华老年骨科与康复电子杂志 ›› 2021, Vol. 07 ›› Issue (05) : 314 -320. doi: 10.3877/cma.j.issn.2096-0263.2021.05.010

综述

老年单侧人工全膝和全髋关节置换术后隐性失血:近况与发展
李超1, 朱燕宾1, 丁凯1, 张奇1, 陈伟1,()   
  1. 1. 050051 石家庄,河北医科大学第三医院创伤急救中心 河北省骨科研究所 河北省骨科生物力学重点实验室
  • 收稿日期:2021-02-23 出版日期:2021-10-05
  • 通信作者: 陈伟
  • 基金资助:
    首批"河北省青年拔尖人才"项目,河北省高层次人才资助项目"三三三人才工程"人才培养资助项目(A201903007)

Hidden blood loss in the elderly after unilateral total knee and total hip arthroplasty: Recent situation and Development

Chao Li1, Yanbin Zhu1, Kai Ding1, Qi Zhang1, Wei Chen1,()   

  1. 1. Department of Traumatology, The Third Hospital Affiliated to Hebei Medical University, Hebei Institute of Orthopaedics and Traumatology, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, China
  • Received:2021-02-23 Published:2021-10-05
  • Corresponding author: Wei Chen
引用本文:

李超, 朱燕宾, 丁凯, 张奇, 陈伟. 老年单侧人工全膝和全髋关节置换术后隐性失血:近况与发展[J/OL]. 中华老年骨科与康复电子杂志, 2021, 07(05): 314-320.

Chao Li, Yanbin Zhu, Kai Ding, Qi Zhang, Wei Chen. Hidden blood loss in the elderly after unilateral total knee and total hip arthroplasty: Recent situation and Development[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(05): 314-320.

全膝关节置换(TKA)和全髋关节置换(THA)是人工关节置换术中最常见的两类手术。尽管微创手术和使用止血带等已从一定程度上缓解了术后出血,但TKA及THA术后患者多有不明原因的贫血症状,血红蛋白降低程度很大但可观察到的失血量却很少,这可能和隐性失血有关。患者术后并发症、切口愈合和功能康复等皆受隐性失血的影响,其逐渐成为了骨科医生们不容忽视的临床问题。隐性失血受围术期多种因素影响,病理生理机制也多样,更因其隐匿性,出现症状时早已发生发展很久,易延误最佳治疗时机,影响术后疗效。本文对隐性失血的可能机制及影响因素加以综述,为积极预防TKA及THA术后隐性失血提供指导意义

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are the most two common types of artificial joint arthroplasty. Although minimally invasive surgery and tourniquet have alleviated postoperative bleeding to a certain extent, most patients with TKA and THA have unexplained anemia symptoms and a large reduction in hemoglobin, but there is little observable blood loss, which may be related to hidden blood loss. The postoperative complications, wound healing and functional rehabilitation of patients are affected by hidden blood loss, which has gradually become a clinical problem that can not be ignored by orthopaedics doctors. Hidden blood loss is affected by many factors in the perioperative period, and the pathophysiological mechanisms are also diverse. Moreover, because of its concealment, the symptoms have already occurred and developed for a long time, which is easy to delay the best treatment opportunity and affect the postoperative curative effect. This paper reviews the possible mechanisms and influencing factors of hidden blood loss, so as to provide guiding significance for actively preventing hidden blood loss after TKA and THA.

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