本文選題：氨甲環(huán)酸　切入點(diǎn)：用藥方法　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討靜脈及局部?jī)煞N用藥方法對(duì)腰椎后路椎間融合術(shù)出血量的影響。方法:選取2015年12月至2016年12月在中國(guó)人民解放軍新疆軍區(qū)總醫(yī)院行腰椎后路椎間融合術(shù)患者90例,隨機(jī)分配為3組:局部組術(shù)中縫合前創(chuàng)口內(nèi)撒入1g氨甲環(huán)酸粉劑,共計(jì)30例(A組);靜脈組將1 g氨甲環(huán)酸粉劑配入100 ml生理鹽水中,手術(shù)切皮前15 min靜脈滴注,共計(jì)30例(B組);空白組術(shù)中不使用氨甲環(huán)酸,共計(jì)30例(C組);兩種用藥方法分別與空白組比較圍手術(shù)期總失血量、顯性失血量、術(shù)后72h隱性失血量、凝血功能[凝血酶原時(shí)間(PT)、活化部分凝血活酶時(shí)間(APTT)、D-二聚體(D-Dimer)]的變化。結(jié)果:靜脈用藥組和空白組相比,圍手術(shù)期總失血量、顯性失血量、術(shù)后72h隱性失血量、凝血功能均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);局部用藥組和空白組相比圍手術(shù)期總失血量、顯性失血量、術(shù)后72h隱性失血量均明顯低于空白組(P0.05),兩組凝血功能相比無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);局部用藥組和靜脈用藥組相比圍手術(shù)期總失血量、顯性失血量、術(shù)后72h隱性失血量均明顯低于靜脈用藥組(P0.05),兩組凝血功能相比無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:后路腰椎椎間融合術(shù)局部應(yīng)用氨甲環(huán)酸可明顯減少圍手術(shù)期總失血量、顯性失血量、術(shù)后72h隱性失血量。靜脈小劑量使用氨甲環(huán)酸對(duì)圍手術(shù)總失血量、顯性失血量及術(shù)后72h隱性失血量無(wú)明顯影響。
[Abstract]:Objective: to investigate the effect of intravenous and local drug therapy on the blood loss of lumbar posterior interbody fusion. Methods: 90 cases of posterior lumbar interbody fusion were performed from December 2015 to December 2016 in Xinjiang military region Hospital of Chinese people's Liberation Army (PLA). Three groups were randomly divided into three groups: 30 cases of group A were treated with intraoperative intraoperative injection of 1 g carbamate powder before suture, and intravenous injection of 1 g of methoxycycline powder into 100ml of normal saline, 15 min before skin incision, intravenously, intravenously, intravenously, intravenously, intravenously, intravenously, and intravenously. A total of 30 patients in Group B, 30 cases in Group C, 30 cases in Group C and 30 cases in Group C, were compared with the control group in the total amount of blood loss during perioperative period, the amount of dominant blood loss, and the amount of recessive blood loss 72 hours after operation. The changes of coagulation function [prothrombin time (PTT), activated partial thromboplastin time (APTTT) D-Dimer]. Results: compared with the control group, the total blood loss, dominant blood loss and recessive blood loss at 72 hours after operation in intravenous medication group were higher than those in control group. There was no significant difference in coagulation function between local drug group and blank group, compared with the control group, the total blood loss and dominant blood loss in the local medication group were higher than those in the control group. 72 hours after operation, the amount of recessive blood loss was significantly lower than that of the blank group (P 0.05), the coagulation function of the two groups was not significantly different from that of the control group (P 0.05), the total blood loss and the dominant blood loss in the local and intravenous groups were higher than those in the control group. 72 hours after operation, the amount of recessive blood loss was significantly lower than that of intravenous medication group (P 0.05), and there was no significant difference in coagulation function between the two groups. Conclusion: local application of carbamoic acid in posterior lumbar interbody fusion can significantly reduce the total blood loss and dominant blood loss during perioperative period. The amount of recessive blood loss at 72 hours after operation was not significantly affected by intravenous low dose of carbamoic acid on the total blood loss, dominant blood loss and 72 hours of recessive blood loss in perioperative patients.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 年利偉;趙建民;李強(qiáng);劉瑞;;術(shù)中浸潤(rùn)氨甲環(huán)酸對(duì)減少腰椎融合手術(shù)術(shù)后失血的療效及安全性評(píng)價(jià)的前瞻性研究[J];中國(guó)矯形外科雜志;2016年07期

2 張嘉男;劉繼軍;賀欣;孟羿彬;黃云飛;吳起寧;高林;楊光;郝定均;;氨甲環(huán)酸浸漬明膠海綿對(duì)腰椎手術(shù)患者術(shù)后出血的影響[J];中華骨與關(guān)節(jié)外科雜志;2015年06期

3 閆學(xué)茂;;兩節(jié)段后路腰椎融合術(shù)前靜注氨甲環(huán)酸的作用與風(fēng)險(xiǎn)研究[J];內(nèi)蒙古醫(yī)學(xué)雜志;2015年07期

4 陳江;賈育松;米博文;孫旗;李晉玉;鄭晨穎;;靜脈聯(lián)合局部應(yīng)用氨甲環(huán)酸對(duì)減少腰椎手術(shù)失血的有效性及安全性研究[J];中國(guó)生化藥物雜志;2015年07期

5 岳辰;謝錦偉;蔡?hào)|峰;楊靜;周宗科;沈彬;康鵬德;裴福興;;靜脈聯(lián)合局部應(yīng)用氨甲環(huán)酸減少初次全髖關(guān)節(jié)置換術(shù)圍手術(shù)期失血的有效性及安全性研究[J];中華骨與關(guān)節(jié)外科雜志;2015年01期

6 孟祥雪;鮑紅光;張曉群;張勇;斯妍娜;謝欣怡;徐亞杰;許常娥;;不同劑量氨甲環(huán)酸對(duì)脊柱手術(shù)患者出血量的影響[J];山東醫(yī)藥;2014年40期

7 卜國(guó)云;吳葉;鄧樹(shù)才;杜區(qū)成;朱加亮;崔成亮;侯樹(shù)勛;;切口內(nèi)應(yīng)用氨甲環(huán)酸對(duì)腰椎后路椎間融合術(shù)后失血的影響[J];中國(guó)矯形外科雜志;2014年18期

8 王璐璐;陳曉亮;;腰椎融合術(shù)的研究進(jìn)展[J];齊魯醫(yī)學(xué)雜志;2011年06期

9 陳兵乾;張烽;;腰椎椎間融合術(shù)的研究進(jìn)展[J];脊柱外科雜志;2007年05期

，

本文編號(hào)：1679585