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在一次性解剖和逆向全肩关节整形手术中,术后贫血和输血的危险因素
Avianna E Arapovic1, Lisa A Galasso2, Hussein S Hamid1,3
1Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
JSES international
|February 2, 2026
概括
在肩关节整形手术后,识别患有输血风险的患者是关键. 女性性别,较高的ASA分数和手术前血红蛋白异常增加了贫血风险,而抗凝固剂和没有TXA增加了输血风险.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 血液学 血液学 血液学
背景情况:
- 门诊患者的肩膀关节整形正在增加.
- 确定患有术后输血风险的患者至关重要.
- 这项研究确定了手术后贫血和输血在初级肩膀关节整形手术中的风险因素.
研究的目的:
- 为了确定手术后贫血的危险因素.
- 为了确定术后输血的危险因素.
- 评估特兰胺酸 (TXA) 在降低输血率方面的作用.
主要方法:
- 从2012-2022年对3,253次原发性肩关节整形手术 (逆向全肩关节整形手术和解剖全肩关节整形手术) 的回顾性审查.
- 不包括修复,骨折相关的病例和半关节整形术的病例.
- 二元逻辑回归分析以确定术后贫血 (血红蛋白<8 g/dL) 和输血的显著风险因素.
主要成果:
- 手术后贫血率为0.01%;输血率为16.3%.
- 贫血的危险因素:女性性别 (OR 2.57),ASA分数> 2 (OR 2.16),手术前血红蛋白异常 (OR 2.40).
- 输血的危险因素:手术前使用抗凝剂 (OR 10.34),缺乏手术前TXA (OR 14.91),年龄大于80岁,女性性别,血液疾病,泌尿生殖系统疾病和rTSA.
结论:
- 女性性别,ASA得分升高和手术前血红蛋白异常是术后贫血的关键预测因素.
- 手术前使用抗凝剂和缺乏TXA是输血的重要风险因素.
- TXA的使用显示出对输血的保护作用,但没有术后贫血.
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