在初级全关节置换术后输血的危险因素
Mohamed Askar1,2, Yasmine Zedan2, Owain Davies1
1Cardiff and Vale University Health Board, Cardiff, UK.
Journal of perioperative practice
|February 14, 2025
概括
在整体关节置换术后进行术后输血是罕见的. 较高的手术前血红蛋白水平显著降低了在关节置换手术后需要输血的风险.
科学领域:
- 整形外科手术 整形外科手术
- 输血医学 输血医学
- 患者安全 患者安全
背景情况:
- 整体关节置换 (THR) 显著提高了患者的生活质量.
- 在THR之后的术后输血是已知的并发症风险因素,包括深层感染.
- 识别输血风险因素对于改善THR结果至关重要.
研究的目的:
- 为了确定与手术后输血相关的独立风险因素,在初级整部关节置换后.
- 提供基于证据的建议,以尽量减少THR患者的输血率.
主要方法:
- 追溯性研究包括2015年1月至2023年12月期间接受初级全关节置换的3901名患者.
- 患者被分为"输血"和"非输血"组.
- 用多变量逻辑回归分析来确定风险因素.
主要成果:
- 只有1.1% (42名患者) 接受了术后输血.
- 手术前的血红蛋白水平是唯一发现的独立风险因素.
- 手术前血红蛋白每增加1g/dL就会使输血几率降低0.3 (95% CI:0.23-0.39).
结论:
- 在整部关节置换术后进行术后输血是罕见的,但存在风险.
- 维持足够的手术前血红蛋白水平是减少输血必要性的关键.
- 建议最低的手术前血红蛋白水平为13g/dL,以减轻输血风险.
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