ABSTRACT
BACKGROUND:Hidden blood loss, a frequent occurrence fol owing artificial joint replacement, greatly affects the recovery from total hip arthroplasty. Many factors have been shown to have a correlation with the hidden blood loss, but the specific mechanism is not yet clear. OBJECTIVE:To investigate the correlation of patients’ baseline (sex, age, underlying disease, obesity), prosthesis types, surgical time with hidden blood loss fol owing total hip arthroplasty, as wel as the association between hidden blood loss and prognosis. METHODS:Ninety patients undergoing total hip arthroplasty were enrol ed in this study. Using Gross formula, we calculated the total blood loss according to height, weight, and pre-and post-operative hematocrit, and subtracted the dominant loss of blood to get the quantitative value of hidden blood loss. According to the criterion, the 90 patients were divided to two groups:group I:volume of hidden blood loss>480 mL, group II:volume of hidden blood loss RESULTS AND CONCLUSION:There were 39 patients in the group I, including 64.1%males, 64.1%hypertension patients, 35.9%diabetic patients, 7.7%patients receiving cement prosthesis;while, there were 51 patients in the group II, including 37.3%males, 25.5%hypertension patients, 5.9%diabetic patients, 35.3%patients receiving cemented prosthesis, showing a significant difference between the two groups. Based on these experimental findings, age, hypertension, diabetes mel itus, type of prosthesis were shown to be factors independently associated with hidden blood loss;however, obesity and smoking exhibited no correlation with hidden blood loss. In addition, a statistical difference in the survival rate was found at admission and during the 1-year fol ow-up.
ABSTRACT
BACKGROUND:The coagulation function of patients after joint replacement is enhanced during the perioperative time, the coagulation disorder can easily lead to the deep vein thrombosis, which wil seriously affect the rehabilitation and prognosis of patients. The embolus fal ing off from venous thrombosis can lead to acute pulmonary embolism, severe cases can be life-threatening. So the early diagnosis of postoperative deep vein thrombosis and acute pulmonary embolism is very important. OBJECTIVE:To review the research progress of clinical diagnosis of thrombosis in the perioperative patients after orthopaedic joint replacement. METHODS:A computer-based retrieve in PubMed database and CNKI database were conducted by the first author for the articles on the clinical diagnosis of thrombosis in the perioperative patients after orthopaedic joint replacement from January 2008 to May 2013 with the key words of“arthroplasty, deep venous thrombosis, pulmonary artery embolism, risk factor, diagnostic approach, anticoagulant, perioperative period, research progress”in English and Chinese. A total of 165 articles were screened out, and final y 50 articles were included according to the inclusion criteria. RESULTS AND CONCLUSION:After joint replacement surgery, various risk factors were associated with the etiology and pathogenesis of deep venous thrombosis, such as vascular and tissue impairments, limb fixation, pain stress, and hemorrhagic fluid caused coagulation disorder, were the main reasons to thrombosis. Deep vein thrombosis and pulmonary embolism had variety of clinical manifestations, many diagnostic approaches were widely applied in clinic, but each one has its laminations. So the positive diagnosis intervention should be performed according to the common clinical manifestations, general y begin from the routine examinations of ultrasound and electrocardiogram, and the combination of various methods was preferred if necessary in order to increase the positive diagnosis rate to the maximum extent, and take drug intervention immediately after diagnosis to avoid the happening of adverse events. Several new types of oral anticoagulants appear in clinical trials, and the outcomes are very promising, but the widely clinical application needs further observation.