分析基于多学科协作的围手术期血液管理方案对人工全膝关节置换术（TKA）中失血量及输血率的影响。

选取哈尔滨医科大学附属第一医院2022年3月至2024年2月期间接受TKA治疗的患者，经纳入标准（终末期膝关节疾病行初次TKA、术前血红蛋白≤100 g/L、凝血功能正常）和排除标准（双侧TKA、氨甲环酸过敏或禁忌、血栓高危或病史、严重心脑血管疾病）筛选，最终选取86例为研究对象。采用随机数字表法将参与者分为对照组（给予常规血液管理方案）和观察组（基于多学科协作的围手术期血液管理方案），每组43例。采用t检验、卡方检验等分析并比较两组术中失血量、输血率、手术时间、血红蛋白（Hb）以及并发症，同时评估两组患者满意度。

观察组的术中失血量、围术期输血量少于对照组，输血率低于对照组，手术时间短于对照组，差异具有统计学意义（t=6.197、12.742、5.988，χ²=4.440，均为P<0.05）。术后第3天，两组患者Hb水平均较术前下降，但是观察组Hb水平高于对照组，差异有统计学意义（t=3.339，P<0.05）。观察组并发症总发生率低于对照组，平均住院时间少于对照组，患者满意度评分高于对照组，两组差异具有统计学意义（χ²=4.440，t=2.917、5.747，均为P<0.05）。

多学科协作的血液管理方案通过精准止血技术、护理团队的动态监测与精准执行及贫血预处理，可减少TKA患者失血与输血需求。护理在执行医嘱、预警并发症及推动早期康复中发挥关键作用，进而加快康复进程，提高患者满意度。

To analyze the impact of a perioperative blood management program based on multidisciplinary collaboration on blood loss and blood transfusion rate during total knee arthroplasty (TKA).

Patients who underwent TKA in the First Affiliated Hospital of Harbin Medical University from March 2022 to February 2024 were selected. After the inclusion criteria (primary TKA for end-stage knee disease, preoperative hemoglobin≤100 g/L, normal coagulation function) and exclusion criteria (bilateral TKA, tranexamic acid allergy or contraindication, high risk or history of thrombosis, severe cardiovascular and cerebrovascular diseases) screening, 86 patients were finally enrolled the study. According to the random number table method, the participants were divided into the control group (given routine blood management scheme) and the observation group (perioperative blood management scheme based on multidisciplinary collaboration), with 43 cases in each group. T test, chi square test and other statistical methods were used to analyze and compare the intraoperative blood loss, blood transfusion rate, operation time, hemoglobin (Hb) and complications between the two groups, as well as the satisfaction of the two groups.

The intraoperative blood loss and perioperative blood transfusion volume in the observation group were less than those in the control group, the blood transfusion rate was lower than that in the control group, and the operation time was shorter than that in the control group (t=6.197, 12.742, 5.988, χ²=4.440), and the differences were statistically significant (all P<0.05). On the third day after the operation, Hb levels of both groups decreased compared with those before the operation, while Hb level of the observation group was higher than that of the control group, and the difference was statistically significant (t=3.339, P< 0.05). The total incidence of complications in the observation group was lower than that in the control group, the average length of hospital stay was shorter than that in the control group, and the patient satisfaction score was higher than that in the control group (χ²=4.440, t=2.917, 5.747), and the differences between the two groups were statistically significant (all P<0.05).

The multidisciplinary blood management program, through precise hemostasis techniques, dynamic monitoring and precise execution by the nursing team, and anemia pretreatment, can reduce blood loss and blood transfusion requirements in patients with total knee arthroplasty (TKA). Nursing plays a crucial role in carrying out medical orders, warning of complications and promoting early rehabilitation, thereby accelerating the rehabilitation process and enhancing patient satisfaction.