胫骨高位截骨术术后贫血的临床研究

Clinical Study on Postoperative Anemia after High Tibial Osteotomy

摘要: 目的：研究内侧开放胫骨高位截骨术(open wedge high tibial osteotomy, OWHTO)患者术后贫血的影响因素，为临床手术提供指导。方法：回顾性分析自2021年1月至2022年12月于我院行HTO手术治疗的患者，共纳入104例，将根据术后两天血红蛋白数值，分为正常组与贫血组，观察两组指标差异。结果：贫血组患者年龄高，身高、体重、BMI低于正常组，住院时长高于正常组，失血量大于正常组，术前血红蛋白偏低，放置引流占比多。两组患者性别、高血压、糖尿病患者占比、K-L分级、术前髋膝踝角(HKA)无统计学差异(P > 0.05)。术前血红蛋白与身高体重成正相关，术后血红蛋白与体重成正相关。其他指标相关性较弱。正常组有1人术后感染，贫血组有5人发生下肢肿胀，5人形成张力性水泡。两组间下肢肿胀与张力性水泡发生率差异有统计学意义。结论：减少围术期失血，不仅可以缩短住院时间，降低住院费用，也可以减少并发症的发生。

Abstract: Objective: To study the impact of postoperative anemia in patients undergoing open wedge high tibial osteotomy (OWHTO) and provide guidance for clinical surgery. Method: A retrospective analysis was conducted on 104 patients who underwent HTO surgery in our hospital from January 2021 to December 2022. They were divided into a normal group and an anemia group based on their hemoglobin values two days after surgery, and the differences in indicators between the two groups were observed. Result: The anemia group patients have a higher age, lower height, weight, and BMI than the normal group, longer hospital stay, greater blood loss than the normal group, lower preoperative hemoglobin, and a higher proportion of drainage placement. There was no significant difference between the two groups in gender, proportion of hypertension and diabetes patients, K-L classification, and preoperative HKA (P > 0.05). Preoperative hemoglobin is positively correlated with height and weight, while postoperative hemoglobin is positively correlated with weight. The correlation between other indicators is weak. One person in the normal group had postoperative infection, five people in the anemia group experienced lower limb swelling, and five people developed tension blisters. There is a statistically significant difference in the incidence of lower limb swelling and tension blisters between the two groups. Conclusion: Reducing perioperative blood loss can not only shorten hospitalization time, lower hospitalization costs, but also reduce the incidence of complications.