在选择性部和膝关节关节整形手术中,不需要进行例行术后全血细胞计评估:前性队列研究
David Moore1,2, Henry Turner1,2, Jess Rotaru2
1Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, D02 YN77, Ireland.
Journal of clinical orthopaedics and trauma
|July 7, 2025
概括
在关节和膝关节置换术后进行常规血红蛋白监测通常是不必要的. 大多数患者不需要输血,这表明需要重新评估目前的全关节置换术术后评估方案.
科学领域:
- 整形外科手术 整形外科手术
- 输血医学 输血医学
- 患者血液管理患者血液管理
背景情况:
- 部和膝盖关节整形术是常见的手术,有可能导致大量的血液损失.
- 目前的做法往往涉及手术后的常规血红蛋白采样,增加输血率而没有明显的发病率/死亡率好处.
- 绝对数值值经常被用来触发输血,而不管个体患者的需求.
研究的目的:
- 确定接受全关节置换的患者中经历血红蛋白显著降低而需要输血的比例.
- 评估常规术后血红蛋白评估在住院和门诊患者队列中的必要性.
- 为了确定选择性部和膝盖关节整形术后输血需求的预测因素.
主要方法:
- 进行了从选择性初级部和膝关节关节塑造病例 (2018-2023) 中前性收集的数据的审查.
- 分析了手术前和手术后的变量,以确定输血预测因素.
- 使用Stata发布17进行了统计分析.
主要成果:
- 在490项手术中,手术后血红蛋白平均下降为2.1g/dL.
- 只有0.8%的患者 (4/490) 需要输血.
- 21.9%的患者接受了日间关节整形手术,没有90天的再入院或并发症.
结论:
- 在选择性全关节整形术后进行例行术后血红蛋白监测通常是不必要的和昂贵的.
- 手术前血红蛋白>11 g/dL的患者可能不需要进行例行术后检查,因为平均下降<3 g/dL是典型的.
- 对于适当选择的患者来说,日间关节整形术被认为是安全的.
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