三种血液损失估计方法的准确性和一致性与HbMass方法对比,用于评估PLIF期间的血液损失
Qianpeng Ma1, Xingyu Duan2,3, Xuewei Wang4
1Department of Orthopedics, The Third Hospital of Shizuishan (Pingluo People's Hospital), Shizuishan, 753000, Ningxia, China.
Journal of orthopaedic surgery and research
|February 8, 2026
概括
与视觉估计和重力测量相比,Gross公式方法是最准确的估计在后腰间体融合 (PLIF) 手术期间的血液损失. 仅仅依靠视觉评估是临床上不可靠的优化患者护理.
科学领域:
- 脊柱手术的结果 脊柱手术的结果
- 手术血液静止和输血医学.
背景情况:
- 准确的手术内流血损失估计对于在后腰间体融合 (PLIF) 期间的患者管理至关重要.
- 目前的方法如视觉估计,重力测量和Gross公式具有不同程度的准确性.
- HbMass 方法作为血液损失量化的参考标准.
研究的目的:
- 为了比较视觉估计,重力测量和总公式方法与HbMass方法的准确性和一致性.
- 确定在PLIF患者中估计血液损失的最可靠方法.
主要方法:
- 一个追溯的队列研究1000连续的PLIF患者.
- 使用视觉,重力测量和总公式方法量化血液损失.
- 从手术前和后的血红蛋白计算HbMass;通过纳德勒方程估计患者的血液体积.
- 使用布兰德-阿尔特曼分析和斯皮尔曼相关性评估的协议.
主要成果:
- 与HbMass.com相比,Gross公式方法显示了最小的偏差 (-28.57 mL) 和最窄的95%一致度极限 (-216.66,159.52 mL).
- 视觉估计显示显著低估和广泛的LoA,表明临床不可靠性 (偏差-238.85mL).
- 重力测量测量结果中度一致 (偏差为-45.33 mL).
结论:
- 总公式方法优于视觉估计和重量计测量,用于PLIF中的血液损失估计.
- 临床实践应该从仅仅依赖视觉评估过渡到总配方方法.
- 在高风险病例中补充HbMass可以进一步优化术后管理并减少并发症.
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