연속적으로 시행한 양측 슬관절 전치환술에서의 자가수혈장치는 술 후 동종수혈량을 감소시킨다
An Autotransfusion Device Reduces the Amount of Allogenic Transfusion in Bilateral Sequential Total Knee Arthroplasty
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목적: 양측 슬관절 전치환술에서 자가수혈장치를 사용한 경우 수술 후 출혈량과 동종수혈 요구량을 얼마나 감소시킬 수 있는지에 대해 조사하였다. 대상 및 방법: 2006년 1월부터 2010년 5월까지 본원에서 양측 슬관절 전치환술을 연속적으로(sequential) 시행받은 95명의 환자들 중 자가수혈장치를 사용하지 않은 50명의 환자들(제1군)과 자가수혈장치를 사용한 45명의 환자들(제2군)에서 출혈량 및 동종 수혈량을 후향적으로 비교 분석하였다. 1군에서는 수술 후 혈색소 수치를 기준으로 하여 동종수혈을 시행하였으며, 2군에서는 수술 후 자가수혈장치에 모인 혈액을 재 주입한 후 혈색소 수치를 기준으로 하여, 다시 동종수혈을 시행하였다. 환자의 의무 기록을 조사하여 총 실혈량, 총 수혈량 등을 확인하였으며 이러한 인자들과 환자의 동종수혈량과의 상관관계를 통계학적으로 비교 분석하였다. 결과: 총 실혈량과 수혈량은 양 군에서 거의 차이를 보이지 않았다. 평균 동종수혈량은 1군에서 1,270.0 mL, 2군에서 564.4 mL고, 이는 2군에서 통계적으로 유의하게 감소하였다(p＜0.05). 결론: 연속적인 양측성 슬관절 전치환술에서 자가수혈장치를 이용한 경우 동종수혈량의 필요성과 양을 줄일 수 있었다.
Abstract
Purpose: This study examined the difference in the reduction of the amount of required allogenic transfusion after bilateral total knee arthroplasty when an autotransfusion device was used. Materials and Methods: The subjects were ninety five patients who underwent sequential bilateral total knee arthroplasty from January 2006 to May 2010 by one surgeon. The first group was 50 patients who did not have an autotransfusion device used and second group of 45 patients were those who had an autotransfusion device used during the postoperative period. Group 1 received allogenic blood transfusion with a standard level of postoperative hemoglobin. The group 2 patients were reinfused with as much blood as was collected by an autotransfusion suction bag and then they received allogenic blood transfusion with a standard level of postoperative hemoglobin. Results: The total blood loss and amount of blood transfusion were almost the same in the two groups. The mean amount of allotransfusion was 1,270.0 mL in group 1 and 564.4 mL in group 2 and the reduced amount of allotransfusion in group 2 was statistically significant (p＜0.05). Conclusion: Using an autotransfusion device is a good method to reduce the mean amount of allotransfusion after bilateral sequential total knee arthroplasty.
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