原著
人工股関節置換術における術中回収式自己血輸血の有用性
キーワード:
total hip arthroplasty,
intraoperative autologous blood transfusion,
allogeneic blood transfusion,
anemia,
blood loss
2017 年 36 巻 2 号 p. 121-124
詳細
2017 年 36 巻 2 号 p. 121-124
Objective: Allogeneic blood transfusion has inherent risks of infection and allergic reactions. We investigated the efficacy of intraoperative autologous blood transfusion during total hip arthroplasty (THA).
Methods: We analyzed 140 patients who underwent primary THA for osteoarthritis or idiopathic osteonecrosis. We compared 106 patients who received intraoperative autologous blood transfusion (group A) and 34 patients who did not (group B). No statistically significant differences were found between the two groups in respect of sex, age, and diagnosis. We investigated the changes of hemoglobin and hematocrit, intraoperative and postoperative blood loss, allogeneic blood transfusion, and complications.
Results: The mean preoperative hematocrit was significantly different between the groups: 38.9±4.3% for group A and 40.8±3.7% for group B (P<0.05). The mean preoperative hemoglobin was not significantly different between the groups: 13.1±1.6 g/dL for group A and 13.7±1.5 g/dL for group B (P=0.12), respectively.
The differences between preoperative and lowest values of hematocrit and hemoglobin were 11.6±3.4% and 4.1±1.2 g/dL for group A, respectively, and 14.1±4.3% and 4.8±1.4 g/dL for group B, respectively. The differences between the two groups were significant (P<0.05). Intraoperative and postoperative blood loss were similar between the two groups. The number of patients who required allogeneic blood transfusion was eight (7.5%) for group A and three (8.8%) for group B. No patient developed early deep infection or sepsis postoperatively. One patient in both group A and B developed deep vein thrombosis.
Conclusion: The ratio of patients requiring allogeneic blood transfusion was not significantly different between the two groups. This can be explained because group A had a higher proportion of patients with anemia preoperatively. Intraoperative autologous blood transfusion in THA slowed the decrease of hematocrit and hemoglobin, and may reduce the need for allogeneic blood transfusion.
