人工膝関節置換術の術後回収式自己血輸血についての検討

Effects of a Postoperative Autologous Blood Salvage System in Total Knee Arthroplasty

　人工膝関節置換術に対する術後回収式自己血輸血の有用性について検討を行った．症例は回収式自己血輸血を行った162例211膝（回収群），行わなかった50例64膝（対照群）である．両群とも可能な症例は術前自己血貯血も行った．同種血輸血を回避できた例は回収群93.5％，対照群90.5％であった．自己血貯血不能例で同種血輸血を回避できた例は回収群81％，対照群74％であった．自己血貯血が可能な症例は回収式自己血の有無に関わらず，ほとんど同種血輸血を必要としなかった．自己血貯血不能例には術後回収式自己血が有意ではないがやや有効であった．

　The purpose of this study was to investigate the usefulness of a postoperative autologous blood salvage system combined with preoperative blood pooling in total knee arthroplasty (TKA). We retrospectively reviewed the clinical records for 211 knees of 162 patients in a salvage group and for 64 knees of 50 patients in a control group. Mean postoperative blood loss was 869.1ml in the salvage group and 630ml in the control group. Allogeneic blood tranfusion was unnecessary in 93.5％ of the cases in the salvage group and 90.5％ of the cases in the control group. Autologous blood pooling alone made allogeneic blood transfusion unnecessary in almost every case. Postoperative blood salvage without autologous blood pooling increased the rate of avoidance of allogeneic blood transfusion from 74％ to 81％, but the difference was not significant.