| Objective:The knee joint is the largest and most complex joint,its blood supply is very rich compared with another generallimbs joint surgery. During total knee arthroplasty, alarge-scale cancellous bone cutting and soft tissuereleasing is needed，and it had much bleeding volume, withhidden blood loss. Especially the bilateral knee replacementoften cause anemia, which is a common complication. Aretrospective study of93patients who underwent primarybilateral total knee arthroplasty (TKA) by Joint SurgeryDepartment in China-Japan Union Hospital of Jilin Hospital wasperformed. The Statistic descriptions of the clinical data ofthese patients were involved, and this paper further studiesfactors affecting the blood loss and blood transfusion inprimary bilateral total knee arthroplasty. The results in thispaper provide suggestion for the treatment of the patients.Method: A retrospective study of the patients who underwentprimary bilateral total knee arthroplasty (TKA) by JointSurgery Department in China-Japan Union Hospital of JilinHospital was performed.93cases were sampled, among which13were male, and80were female. The clinical data, including thephysiological indexes and the test results, was collected by clinical records and other means. According to the order ofbefore, during and after surgery, data was collected:diagnosis,gender, age, height, weight, body mass index, preoperativehemoglobin, preoperative HCT, past medical history, ASAanesthesia risk classification, operation time,intraoperative infusion quantity, total amount of bloodtransfusion, postoperative hemoglobin, postoperative HCT, anduse of the related drugs. The Statistic descriptions of theclinical data of these patients were involved, and accordingto the amount of blood transfusions, I divide the patients intotwo groups, various indexes of two groups were compared,analysis the factors affecting the patients’ blood transfusionvolume. SPSS20.0statistical software package proceeds wereused for statistics analysis, continuous variables wereanalyses with t test, classification variables were analyzedwith chi-square test, and the corresponding statistics and pvalue were recorded. P <0.05means a statistically significantdifference, and P <0.01means a statistically very significantdifference.Results:93cases were sampled in the study, some of theimportant statistical results: the average age of patients was64±8(40～83) years old, female accounted for86.0%. The average preoperative hemoglobin was130±15(91～181) g/L, theaverage operation time3.51±0.82(1.67～5.83) hours, averageblood transfusions was5.7±3.3(0～17.5) U. The averagetotal blood loss was1510±368ml (650～2560ml), the recessiveblood loss was780±262ml (430～1510ml), accounting for51.7%of the total blood loss. The patients were divided into twogroups according to of blood transfusions, the results showedthat the operation time of the two groups has statistically verysignificant difference (P=0.00013), OR value is4.0.Preoperative hemoglobin (110g/L for boundary value) of thetwo groups have statistical significant difference (P=0.030),OR value is4.8, no statistical significance was observed withthe rest of the indexes (P＞0.05).Conclusion:(1) The majority of patients who underwent primarybilateral total knee arthroplasty are elderly female patients,perioperative blood loss and blood transfusion volume of thesepatients is higher;(2) preoperative anemia and operativeduration is the patients’ blood transfusion volume increasingnumber of important risk factors, it is suggested that bloodroutine examination should be done one month ahead of operationday, and try to shorten the operative duration. |
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