Effect of perioperative temperature protection on the coagulation function during total knee arthroplasty / 中国组织工程研究

ABSTRACT

BACKGROUND:Perioperative hypothermia may lead to coagulation function for patients undergoing total knee arthroplasty,and an increase in blood loss.OBJECTIVE:To compare the influence of temperature protection with non-temperature protection on coagulation function in patients undergoing total knee arthroplasty.METHODS:Forty ASA Ⅰ-Ⅱ patients scheduled for total knee arthroplasty were randomly divided into temperature protection and non-temperature protection groups (n=20 per group).The patients in the temperature protection group underwent heat-preservation including preheating room temperature,actively blanket warmer,were infused or flushed with fluids of 37 ℃ by heating apparatus;the patients in the non-temperature protection group received full-body-covered cotton quilt only.The nasopharyngeal temperature were detected at postoperative 10 minutes,intraoperative 1 hour and postoperative 1 hour,and 1.25 mL of venous blood were collected to detect the fibrin formation time,blood clot formation time,and maximum amplitude using thrombelastography.Additionally,the intraoperative blood loss and volume of drainage at postoperative 24 hours were recorded.RESULTS AND CONCLUSION:(1) The nasopharyngeal temperature in the non-temperature protection group was significantly lower than that in the temperature protection group at postoperative 1 hour (P ＜ 0.05).(2) The intraoperative blood loss and volume of drainage at postoperative 24 hours in the temperature protection group were significantly less than those in the non-temperature protection group (P ＜ 0.05).(3) Compared with the temperature protection group,fibrin formation time and blood clot formation time at intraoperative and postoperative 1 hour were significantly lengthened,and maximum amplitude at postoperative 1 hour was significantly shortened in the non-temperature protection group (P ＜ 0.05).(4) These findings show that intraoperative hypothermia can weaken platelet function,inhibit coagulation factor activity,and increase the amount of blood loss and drainage.In the meanwhile,heat-preservation is able to reduce the loss of body heat,improve coagulation function and reduce blood loss for patients undergoing knee replacement.