目的 评估术后早期功能锻炼对全髋关节置换术(total hip arthroplasty,THA)患者围手术期隐性失血(hidden blood loss,HBL)的影响.方法 回顾性分析142例在某医院接受THA手术的老年股骨颈骨折患者的临床资料.根据早期进行功能锻炼的强度,将患者分为少量功能锻炼组和正常功能锻炼组.正常功能锻炼组82例患者在康复医师的指导下完成了正常强度或超过正常的主动功能锻炼,少量功能锻炼组60例患者完成的主动锻炼强度低于正常强度的一半.根据患者入院时和术后第5天的血液指标来计算总失血量、总失血量/原血容量、HBL量、HBL量/总失血量.分析术后早期功能锻炼的强度对THA围手术期失血和HBL的影响.结果 两组患者入院时一般资料比较,差异均无统计学意义(P＞0.05),具有可比性.正常功能锻炼组THA患者总失血量、总失血量/原血容量、HBL量、HBL量/总失血量以及高HBL比例明显低于少量功能锻炼组(P均＜0.05).结论 THA术后早期功能锻炼能有效减少THA患者围手术期的HBL量,且对术后显性出血及伤口愈合影响较小.
Effect of Early Functional Exercise on Perioperative Hidden Blood Loss in Patients with Total Hip Arthroplasty
Objective To investigate the impact of early functional exercise on perioperative hidden blood loss(HBL)in patients undergoing total hip arthroplasty(THA).Methods A total of 142 elderly patients with femoral neck fractures who underwent THA at author'hospital were retrospectively analyzed.These patients were categorized into lit-tle functional exercise group and normal functional exercise group based on the intensity of their functional exercise.In the normal functional exercise group,82 patients completed normal intensity or more than normal active function exercise un-der the guidance of rehabilitation doctors,in the little functional exercise group,60 patients completed the active exercise intensity less than half of the normal intensity.The total blood loss,total blood loss/original blood volume,HBL vol-ume,HBL volume/total blood loss were calculated according to the blood indexes of the patients at admission and the 5 th day after surgery.The impact of early functional exercise intensity on perioperative blood loss and HBL after THA was analyzed.Results There were no significant differences in general information at admission between the two groups(P＞0.05).The total blood loss,total blood loss/original blood volume,HBL volume,HBL volume/total blood loss and the proportion of high HBL in the normal functional exercise group were significantly lower than those in the little functional exercise group(all P＜0.05).Conclusion Early functional exercise after THA can effectively reduce the amount of peri-operative HBL of THA patients,and has little effect on postoperative overt bleeding and wound healing.
Femoral neck fractureTotal hip arthroplastyHidden blood lossPerioperative periodFunctional exercises
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