ABSTRACT
BACKGROUND:How to effectively reduce al ogeneic blood transfusion volume after knee arthroplasty has become a new clinical problem, but predictors of perioperative blood loss and al ogenic blood transfusion after replacement have not been wel defined. OBJECTIVE:To establish the prediction model of al ogeneic transfusion volume after total knee arthroplasty by analyzing the preoperative and intraoperative related factors that influence the postoperative al ogeneic transfusion volume, so as to provide a theoretical basis for the clinical selective application of the autologous blood retransfusion device. METHODS:The materials of 120 postoperative al ogenic transfusion patients who treated with unilateral total knee arthroplasty at Baodi Clinical Col ege of Tianjin Medical University from January 2012 to December 2013 were retrospectively analyzed. Each patient’s gender, age, height, body weight, preoperative hemoglobin value, operation time, intraoperative blood loss volume and postoperative al ogeneic transfusion volume were recorded in detail, and accordingly a prediction model of al ogeneic transfusion volume was established after total knee arthroplasty. From January 2014 to December 2014, we applied this model in clinic. A total of 90 patients who predicted need for al ogeneic transfusion after unilateral total knee arthroplasty were randomly divided into two groups. Autologous blood retransfusion device was used in the observation group. Conventional drainage was used in the control group. The blood transfusion volume of patients in these two groups was analyzed, and the prediction accuracy of the prediction model in these two groups was detected. RESULTS AND CONCLUSION:Al patients completed the experimental observation. Pearson analysis showed that the patient’s age, height, body weight, preoperative hemoglobin values, operation time and intraoperative blood loss volume associated with postoperative al ogeneic transfusion volume (P0.05). There were significant differences in al ogeneic transfusion volume and total blood transfusion volume (including autologous and allogeneic blood transfusion volume) of patients in these two group (P<0.01). The al ogeneic transfusion volume in the observation group was significantly lower than that in the control group. These results suggest that the prediction model can successful y predict the al ogeneic transfusion volume after total knee arthroplasty. The application of autologous blood retransfusion device in those patients who predicted need for postoperative al ogenic transfusion after the replacement can effectively reduce the al ogenic transfusion volume.
ABSTRACT
Objective The study was to explore the effect of the Wechat combined with discharge supervision on rehabilitation of empty-nesters with total knee arthroplasty (TKA).Methods 100 emptynesters who were treated with unilateral TKA from September 2013 to August 2014 were selected and randomly divided into the experimental group and the control group with 50 patients in each group.All patients received the same orthopaedic hospital routine therapy and nursing,hospital rehabilitation exercise,guidance,family visits and conventional outpatient care.Besides the above treatment,the experimental group received nursing instruction after discharge by professional nurses through Wechat platform,which included functional exercise guidance,psychological guidance and daily activities instructions.The hospital for special surgery(HSS) knee score and the modified Barthel Index (MBI) score were assessed on the 14th day,the third month and the sixth month after surgery.Results HSS knee score and MBI score had no statistically significant difference between the experimental group and the control group on the 14 th day after surgery; HSS knee score and MBI score of the experimental group on the third month and the sixth month after surgery were significantly higher than those of the con-trol grou,t value was 9.24,11.07 and 21.92,14.14.Conclusions Wechat combined with discharge super-vision can effectively improve the rehabilitation effect of empty-nesters after total knee arthroplasty.