《中华骨与关节外科杂志》2022年10月第15卷第10期Chin J Bone Joint Surg,VoL.15,No.10,Oct.2022733国家卫生健乘委加速康复外科专家委员会骨科专家组，中国研究型医院学会骨科加速康复专业委员会，中国康复技术转化及促进会骨科加速康复专业委员会】骨科加速康复围手术期血液管理专家共识.中华骨与关节外科杂志，2022,15(10少：733-738.·专家共识·骨科加速康复围手术期血液管理专家共识国家卫生健康委加速康复外科专家委员会骨科专家组，中国研究型医院学会骨科加速康复专业委员会，中国康复技术转化及促进会骨科加速康复专业委员会【摘要】骨科手术较高的术前贫血发生率、术中出血量及术后异体输血率是阻碍患者功能康复的主要问题，做好围手术期血液管理是骨科加速康复的关键技术。为了进一步加强骨科加速康复围手术期血液管理在临床的应用、提高医疗质量和安全，国家卫生健康委加速康复外科专家委员会骨科专家组、中国研究型医院学会骨科加递康复专业委员会、中国康复技术转化及促进会骨科加速康复专业委员会联合相关学科专家成立骨科加递康复系列共识编写专家委员会，以临床问题为导向、遵循循证医学原则，归钠出4个方面的问题：①术前血液管理（术前贫血筛查与治疗、创伤骨科患者术前血液管理、术前预存自体输血、术前血小板减少症的诊疗）：②术中血液管理（微创理念优化手术操作、控制性降压、应用氨甲环酸、自体血液回输、特殊技术、术中贫血监测）：③术后血液管理（术后贫血监测、术后出血及止血、术后贫血的预防与治疗)：④围手术期单病种手术输血评估机制。按照上述4个方面的问题进行文献检索和归钠，结合2017版《中国骨科手术加速康复一围术期血液管理专家共识》及近5年国内外最新研究进展，更加细化了术前、术中、术后的血液管理措施与择期手术围手术期单病种手术输血评估机制。经过反复讨论和修改后形成本共识，期望其为我国骨科加速康复围手术期血液管理的多学科协作起到积极的推动作用，最终达到加速患者康复的目的。【关键词】骨科手术；加速康复外科；血液管理；输血评价【中图分类号】R68【文章编号】2095-9958(2022)10-0733-06【文献标志码】AD0:10.3969i.issn.2095-9958.2022.10.03Expert consensus on perioperative blood management in orthopaedics in enhancedrecovery after surgery programOrthopaedic Expert Group of ERAS profession Committee of National Health Commission,Orthopaedic ERAS profession Committeeof Chinese Research Hospital Association,Orthopaedic ERAS profession Committee of China Association of RehabilitationTechnology Transformation and PromotionCorresponding Author:NIU Ting,QIU Guixing.PEI Fuxing[Abstract]The high incidence of preoperative anemia,intraoperative blood loss and postoperative allogeneic blood transfusion rate inorthopaedic surgery are the main problems that hinder the functional rehabilitation of patients.Perioperative patient blood management(PBM)is the key to accelerate the implementation and promotion of the concept of enhanced recovery after surgery.In order to furtherrefine the perioperative PBM of orthopaedic surgery and improve medical quality and safety,Orthopaedic Expert Group of ERASprofession Committee of National Health Commission,Orthopaedic ERAS profession Committee of Chinese Research HospitalAssociation,Orthopaedic ERAS profession Committee of China Association of Rehabilitation Technology Transformation andPromotion,together with experts from other relevant disciplines,established a collaborative expert committee for this consensuswriting.Focusing on the clinical problems and following evidence-based medicine principles,the experts summarized the followingfour aspects:Opreoperative PBM (preoperative anemia screening and treatment,preoperative blood loss prevention and correction ofpreoperative acute anemia for patients with orthopaedic trauma,pre stored autologous blood transfusion,diagnosis and treatment ofpreoperative thrombocytopenia);2intraoperative PBM (minimally invasive concept involved operation technique,controlled bloodpressure reduction,tranexamic acid application,autoblood recycle,anemia monitoring and other special technology);3postoperativePBM(anemia monitoring.bleeding and hemostasis,prevention and treatment of anemia),ev
