Retrospective Study On Early Risk Factors Of Hypoproteinemia After Total Knee Arthroplasty

[Objectives]1、Changes of serum albumin level was observed for 3 days after total knee arthroplasty;2、To explore risk factors among the patients with hypoproteinemia 3 days after total knee arthroplasty.3、To analyze the correlation between risk factors and the changes of serum albumin, provide basis for assessment of prejudgment for the occurrence of hypoproteinemia.[Methods]104 cases of total knee arthroplasty from December 2011 to December 2013 in our hospital,were collected and divided into normal albumin group(X>25g/L) and hypoproteinemia group (X≥25g/L),acorrding to the albumin measurements (X)by 72 hours after operation.The level of serum albumin at the different time, the incidence of hypoalbuminemia of different causes,and Clinical observation indexes were observed and analyzed.[Results]1.In 104 cases of patients 3 days after total knee arthroplasty general hypoproteinemia incidence rate was 26.9%, of which,21.3% osteoarthritis patients complicated with postoperative hypoproteinemia,47.8% rheumatoid arthritis complicated with postoperative hypoproteinemia,16.7% synovial osteochonromatosis in postoperative patients with hypoalbuminemia.2.The numbers of patients with hypoalbuminemia were growing within 3 days after artificial knee replacement in the research,the average levels of serum albumin during the same period of the normal group and the patient group were significant difference (P<0.01).:both of tow groups, the mean preoperative levels were in the normal range, decreased significantly after operation, the sharpest decline occurred on the day of the operation,to a minimum on the third day after operation(incidence rate was 26.9%); All observation periods cases albumin average lower than that of normal group.3. The case group in age, intraoperative blood loss, postoperative hemoglobin decreased volume, postoperative drainage volume, C- reactive protein, ESR, procalcitonin, white blood cell count, preoperative albumin level, operation time and tourniquet time on a single counting statistics had significant difference compared with the normal group(P<0.05).4. Through correlation analysis, the results showed that the level of serum albumin decrease with age, intraoperative blood loss, postoperative drainage, postoperative hemoglobin decrease, C-reactive protein, erythrocyte sedimentation rate, white blood cell count, preoperative albumin level,operation time, single tourniquet time was positively correlated (P>0.05,r>0.4), and procalcitonin has no obvious correlation (P>0.05). One of the largest degree of association of CRP (P=0.011,r=0.957), the correlation degree is the smallest WBC (P=0.044,r=0.478).5. The case group with significant difference between the types of diseases and the normal group (P<0.01), more than two cases of basic diseases were accompanied by, diseases of the respiratory system, cardiovascular system diseases, diabetes, a higher proportion of patients with abnormal liver function; without concomitant disease patients than in patients with high normal group.6. Using two logistic regression:age, operative time, blood loss in single tourniquet time, intraoperative volume, postoperative drainage volume, weight,CRP,preoperative albumin decreased hemoglobin after surgery were statistically significant difference (P<0.05)[Conclusions]1. Serum albumin content decreased in 3 days after total knee arthroplasty, the sharpest decline occurred on the day of the operation.2. Serum albumin levels decrease with age, preoperative albumin level, operation time, single tourniquet time, blood loss, C-reactive protein and other relevant clinical indexes were positively correlated 3 days after the operation,and with no correlationprocalcitonin.3.70 years of age or older, preoperative serum albumin content is lower than 35g/L, operation time is larger than 3h, the single tourniquet time was more than 90min, the amount of intraoperative bleeding, postoperative anemia is greater than or equal to 200ml,postoperative CRP increasing are hypoproteinemia risk factors after total knee arthroplasty.