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中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (05) : 622 -629. doi: 10.3877/cma.j.issn.1674-134X.2025.05.013

综述

全膝关节置换术中血液管理的研究进展
王冠乔, 陈波波, 王宏煜, 郭晓祺, 谢海彬, 田野†()   
  1. 110000　沈阳，中国医科大学附属盛京医院脊柱关节外科
  • 收稿日期:2025-01-19 出版日期:2025-10-01
  • 通信作者: 田野
  • 基金资助:
    国家自然科学基金(82470923); 辽宁省教育厅项目(LJKMZ20221164); 盛京医院345人才计划

Progress of blood management in total knee arthroplasty

Guanqiao Wang, Bobo Chen, Hongyu Wang, Xiaoqi Guo, Haibin Xie, Ye Tian†()   

  1. Shengjing Hospital of China Medical University, Shenyang 110000, China
  • Received:2025-01-19 Published:2025-10-01
  • Corresponding author: Ye Tian
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引用本文：

王冠乔, 陈波波, 王宏煜, 郭晓祺, 谢海彬, 田野. 全膝关节置换术中血液管理的研究进展[J/OL]. 中华关节外科杂志(电子版), 2025, 19(05): 622-629.

Guanqiao Wang, Bobo Chen, Hongyu Wang, Xiaoqi Guo, Haibin Xie, Ye Tian. Progress of blood management in total knee arthroplasty[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2025, 19(05): 622-629.

全膝关节置换术围手术期血液管理是保障手术安全、促进功能恢复的关键环节。近年来研究显示，微创技术虽可加速术后早期康复，但对围手术期失血量的影响有限；限时、低压止血带应用有助于降低并发症发生率；氨甲环酸静脉与局部联合给药较单一途径可显著减少失血；控制性降压及术中自体血回收能够有效降低异体输血需求及相关风险。多策略联合干预可进一步优化全膝关节置换术围手术期血液管理，但其个体化实施方案尚需高质量临床证据支持。

关键词: 关节成形术，置换，膝, 骨关节炎, 止血带, 氨甲环酸, 降压，控制性

Perioperative blood management in total knee arthroplasty (TKA) is a critical measure for ensuring surgical safety and enhancing functional recovery. Recent evidence indicates that while minimally invasive techniques can expedite early postoperative rehabilitation, their effect on perioperative blood loss is limited. The use of tourniquets with restricted duration and low pressure can help reduce complication rates. Combined intravenous and topical administration of tranexamic acid is more effective in reducing blood loss than either route alone. Controlled hypotension and intraoperative blood salvage can significantly decrease the need for allogeneic transfusion and its associated risks. Integrating multiple strategies may further optimize perioperative blood management in TKA, however, individualized protocols still require confirmation by high-quality clinical studies.

Key words: Arthroplasty, replacement, knee, Osteoarthritis, Tourniquets, Tranexamic acid, Hypotension, controlled
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