本文關(guān)鍵詞： 關(guān)節(jié)成形術(shù) 置換 膝 靜脈血栓形成 麻醉 麻醉 硬膜外 植入物 人工假體 膝關(guān)節(jié)置換 下肢靜脈血栓形成 全身麻醉 硬膜外麻醉 Meta分析　出處：《中國組織工程研究》2015年35期 　論文類型：期刊論文

【摘要】：背景:雖然全膝關(guān)節(jié)置換治療嚴重膝關(guān)節(jié)炎患者療效可靠,但是,下肢靜脈血栓形成仍會在很多患者中發(fā)生,因此下肢靜脈血栓形成也成了目前接受全膝關(guān)節(jié)置換后突然死亡的最主要原因。目的:比較不同麻醉方式下進行全膝關(guān)節(jié)置換后下肢靜脈血栓形成的差異。方法:利用"total knee arthroplasty","TKA","thrombosis","DVT","randomized controlled trial","RCT","全膝關(guān)節(jié)置換""血栓""麻醉"等關(guān)鍵詞在"Pub Med","Medline","Elsevier","Embase","Cochrane library","萬方","CNKI"等國內(nèi)外主要數(shù)據(jù)庫搜集了2000年1月到2015年3月期間發(fā)表的涉及到不同麻醉方式對膝關(guān)節(jié)置換后下肢深靜脈血栓形成的影響方面的文獻資料。通過雙盲法進行數(shù)據(jù)提取,文獻質(zhì)量評估,并利用Revman5.3統(tǒng)計軟件對所提取的數(shù)據(jù)進行了meta分析。結(jié)果與結(jié)論:最后總共有包含885例患者的8個文獻被納入此研究。通過分析發(fā)現(xiàn)在納入的文獻之間不存在顯著異質(zhì)性(I2=0,P=0.72)。數(shù)據(jù)合成后的OR是0.25(95%CI:0.18,1.35),說明利用連續(xù)硬膜外麻醉方式進行全膝關(guān)節(jié)置換能顯著降低術(shù)后深靜脈血栓形成的可能。因為缺乏全身麻醉與硬膜外麻醉下的患者凝血因子變化情況等數(shù)據(jù),硬膜外麻醉降低深靜脈血栓發(fā)生率的機制尚需進一步研究。說明在接受下肢靜脈血栓的患者中,利用連續(xù)硬膜外麻醉可顯著降低下肢靜脈血栓的形成可能。因此在下肢靜脈血栓形成高�；颊咧袘�(yīng)該優(yōu)先使用硬膜外麻醉方式進行膝關(guān)節(jié)置換。
[Abstract]:Background: although total knee arthroplasty is effective in the treatment of severe knee arthritis, venous thrombosis of lower extremity still occurs in many patients. Therefore, venous thrombosis of lower extremity has become the main cause of sudden death after total knee arthroplasty. Methods: using "total knee arthroplasty" to compare the differences of venous thrombosis in lower extremity after total knee arthroplasty under different anesthetic methods. "TKA", "thrombosis", "DVT", "randomized controlled trial", "RCT". The keywords of "total knee arthroplasty", "thrombus", "anesthesia" were "Pub Med", "Medline", "Elsevier", "Embase". "Cochrane library", "Wanfang". "CNKI" From January 2000 to March 2015, literature about the influence of different anesthetic methods on deep venous thrombosis of lower extremity after knee arthroplasty was collected. Double blind method for data extraction. Literature quality assessment. The extracted data are analyzed by meta using Revman5.3 software. Results and conclusions:. Finally, a total of 8 articles including 885 patients were included in the study. I20. The OR after data synthesis is 0.25 / 95 CI: 0.18 / 1.35). The results showed that total knee arthroplasty with continuous epidural anesthesia could significantly reduce the possibility of deep venous thrombosis after operation because of the lack of data on coagulation factors of patients under general anesthesia and epidural anesthesia. The mechanism of epidural anesthesia in reducing the incidence of deep venous thrombosis needs further study. The possibility of venous thrombosis in lower extremity can be significantly reduced by continuous epidural anesthesia. Therefore, epidural anesthesia should be given priority in knee arthroplasty in patients with high risk of lower extremity venous thrombosis.
【作者單位】： 北京積水潭醫(yī)院;清華大學(xué)醫(yī)學(xué)中心;
【分類號】：R614
【正文快照】： INTRODUCTIONThe invention of total knee arthroplasty(TKA)is one of the most significant advancements inthe 20th century medicine.This technique haseffectively alleviated the pain of patients withlate-stage osteoarthritis,enhanced their abilityof mobility

【共引文獻】

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本文編號：1449116