全髋关节置换术后总失血量和血生化指标变化的量效关系

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Abstract Objective To investigate the pattern of changes in serum potassium, calcium, albumin (ALB) and hemoglobin (HGB) after traumatic total hip replacement (THA), so as to provide a basis for perioperative safety management. Methods The data of 112 patients who underwent THA for femoral neck fracture at the Department of Arthroplasty of Yueyang People's Hospital from September 2017 to September 2022 were retrospectively analyzed. Results The mean total blood loss after THA was (798.74±265.34) mL, and the hidden blood loss was (428.12±195.45) mL, accounting for 54.21% of the total blood loss; serum calcium, ALB, and HGB levels decreased significantly after total hip replacement compared with preoperative levels, while serum potassium levels did not change significantly compared with preoperative levels; total THA blood loss was significantly and positively correlated with the amount of change in patients’ serum calcium, ALB and HGB, and the regression equations were Y=0.000216X, Y=0.00919X, Y=0.0280X, with R²: 0.738, 0.860, 0.945, respectively; The incidence of postoperative biochemical index abnormalities was significantly increased in patients with preoperative serum calcium <2.27mmol/L, ALB<37.26g/L, HGB<122.11g/L. Conclusion There is a quantitative relationship between the decrease in serum calcium, ALB, and HGB concentrations and the total blood loss in THA. In clinical practice, the change values of postoperative blood biochemical indexes can be predicted based on the mean blood loss in the general population, so as to set up the preoperative warning value of relevant indicators, which provides effective help to estimate the changes of corresponding indicators after THA and advance intervention.

Key words： total hip arthroplasty total blood loss hypocalcemia hypoproteinemia anemia

Received: 30 October 2022

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	CAO Yang
	LIU Fang

Cite this article:

CAO Yang,LIU Fang. Volume-effect relationship between total blood loss and serum biochemical index changes after total hip arthroplasty[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(1): 76-79.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I1/76

[1] Pflüger MJ, Frömel DE, Meurer A.Total Hip Arthroplasty Revision Surgery: Impact of Morbidity on Perioperative Outcomes[J]. J Arthroplasty, 2021, 36(2): 676-681.
[2] Wu XD, Zhu ZL, Xiao PC, et al.Are Routine Postoperative Laboratory Tests Necessary After Primary Total Hip Arthroplasty[J]. J Arthroplasty, 2020, 35(10): 2892-2898.
[3] Nadler SB, Hidalgo JH, Bloch T.Prediction of blood volume in normal human adults[J]. Surgery, 1962, 51(2): 224-232.
[4] Tian S, Li H, Liu M, et al.Dynamic Analysis of Perioperative Hidden Blood Loss in Intertrochanteric Fractures[J]. Clin Appl Thromb Hemost, 2019, 25: 1076029618823279.
[5] 邵丹, 周业明. 回归常数的显著性检验[J]. 科学技术与工程, 2007, (08): 1715-1716, 1739.
[6] 曲鹏飞, 王慧声, 李锡. 初次全膝关节置换失血量与置换后低白蛋白血症、低钙血症的相关性[J]. 中国组织工程研究, 2022, 26(3): 392-398.
[7] 杨莉娜, 吴永红, 侯彦深.340例患者围术期电解质变化的临床分析及护理安全[J]. 新疆医学, 2016, 46(12): 1517-1519.
[8] 刘子桃, 黄永明. 膝关节置换患者围手术期钠、钾、钙离子水平的变化及临床意义[J]. 当代医学, 2012, 18(23): 22-24.
[9] 沈军, 卫晓恩. 髋、膝关节置换术围手术期快速康复新理念[J]. 上海医药, 2017, 38(08): 7-9, 16.
[10] Gai P, Sun H, Sui L, et al Hypocalcaemia After Total Knee Arthroplasty and its Clinical Significance[J]. Anticancer Res, 2016, 36(3): 1309-1311.
[11] 罗辉遇, 谢长江, 刘卫江, 等. 大手术重症患者血浆钙离子水平的变化及临床意义[J]. 国际医药卫生导报, 2006, (05): 7-9.
[12] 郑建方, 舒建胜, 李欣华, 等. 血清钙在多发伤早期的浓度变化及其意义[J]. 中华创伤杂志, 2005, (03): 75-76.
[13] Boniello AJ, Simon MS, Emenari CC, et al.Complications and Mortality Following Total Hip Arthroplasty in the Octogenarians: An Analysis of a National Database[J]. J Arthroplasty, 2018, 33(7S): S167-S171.
[14] Ryan S, Politzer C, Fletcher A, et al.Preoperative Hypoalbuminemia Predicts Poor Short-term Outcomes for Hip Fracture Surgery[J]. Orthopedics, 2018, 41(6): e789-e796.
[15] Alvarez-Nebreda ML, Bentov N, Urman RD, et al.Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI)[J]. J Clin Anesth, 2018, 47: 33-42.
[16] Viola J, Gomez MM, Restrepo C, et al.Preoperative anemia increases postoperative complications and mortality following total joint arthroplasty[J]. J Arthroplasty, 2015, 30(5): 846-848.
[17] Conlon NP, Bale EP, Herbison GP, et al.Postoperative anemia and quality of life after primary hip arthroplasty in patients over 65 years old[J]. Anesth Analg, 2008, 106(4): 1056-1061
[18] Allain JP, Stramer SL, Carneiro-Proietti AB, et al.Transfusion-transmitted infectious diseases[J]. Biologicals, 2009, 37(2): 71-77.
[19] Rosencher N, Kerkkamp HE, Macheras G, et al.Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe[J]. Transfusion, 2003, 43(4): 459-469.
[20] 王友华, 刘璠, 王洪, 等. 人工全髋关节置换对红细胞脂质过氧化的影响[J]. 江苏医药, 2006, (07): 615-617.
[21] Hong WS, Zhang YX, Lin Q, et al.Risk Factors Analysis and the Establishment of Nomogram Prediction Model of Hidden Blood Loss After Total Hip Arthroplasty for Femoral Neck Fracture in Elderly Women[J]. Clin Interv Aging, 2022, 17: 707-715.
[22] 徐剡, 雷西凤, 张桂彬, 等. 不同病因行全髋关节置换术患者总失血量和隐性失血量差异分析[J]. 河北医药, 2019, 41(22): 3393-3396.