本文選題：關節(jié)成形術 + 置換　； 參考：《中國全科醫(yī)學》2015年06期

【摘要】：目的探討采用關節(jié)內注射氨甲環(huán)酸聯合引流管夾閉3 h方案減少初次單膝關節(jié)置換術患者圍術期失血量的有效性和安全性。方法選取2013年12月—2014年2月安徽醫(yī)科大學附屬省立醫(yī)院骨科行單側首次全膝關節(jié)置換術的老年患者90例(90膝),采用隨機數字表法將患者分為試驗組與對照組,每組45例�；颊呔晟菩g前常規(guī)檢查,同時行雙下肢靜脈彩超,試驗組于手術關閉筋膜層后關節(jié)內注射氨甲環(huán)酸并夾閉引流管3 h,對照組關節(jié)內注射20 ml 0.9%氯化鈉溶液并維持引流管開放,兩組患者引流管均于術后48 h拔除。記錄術前兩組患者年齡、性別、左/右側、體質指數、手術時間、美國麻醉師協會(ASA)評分、凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、纖維蛋白原(FIB)水平,術前及術后1、3 d血紅蛋白及血細胞比容(HCT),總失血量、術后引流量、隱性失血量、輸血量。結果兩組患者年齡、性別、左/右側、體質指數、手術時間、ASA評分、PT、APTT、FIB水平比較,差異均無統(tǒng)計學意義(P0.05)。兩組患者術前及術后1、3 d血紅蛋白及HCT比較,差異均有統(tǒng)計學意義(P0.05);治療方法與治療時間存在交互作用(P0.05)。試驗組患者術后總失血量、術后引流量、隱性失血量、輸血量較對照組均減少(P0.05)。兩組患者的手術切口均一期愈合,且均未出現嚴重并發(fā)癥和不良反應,術后第7天復查雙下肢靜脈彩超均未發(fā)現靜脈血栓。結論關節(jié)內注射氨甲環(huán)酸聯合引流管夾閉3 h方案可有效減少初次單膝關節(jié)置換術后的血液丟失,同時不增加下肢深靜脈血栓等發(fā)生率,該方案有效、安全。
[Abstract]:Objective to investigate the efficacy and safety of intraarticular injection of methacylic acid combined with drainage tube clamping for 3 h in the reduction of perioperative blood loss in patients undergoing primary single knee arthroplasty. Methods from December 2013 to February 2014, 90 elderly patients undergoing unilateral total knee arthroplasty in Department of Orthopaedics, affiliated Hospital of Anhui Medical University, were randomly divided into experimental group (n = 45) and control group (n = 45). All the patients were performed routine examination before operation, and both lower extremity venous ultrasound was performed. The experimental group was treated with intraarticular injection of aminocyclylic acid and clamping drainage tube for 3 h after the fascial layer was closed, while the control group was treated with 20 ml 0.9% sodium chloride solution intraarticularly and the drainage tube was kept open. The drainage tubes were removed 48 hours after operation in both groups. Age, sex, left / right side, body mass index, operation time, ASAs score, prothrombin time (PTT), activated partial thromboplastin time (APTTT), fibrinogen FIBs (FIBs) were recorded. Before and 1 day after operation, hemoglobin and HCT volume, total blood loss, postoperative drainage, recessive blood loss and blood transfusion volume were measured. Results there was no significant difference in age, sex, left / right side, body mass index, ASA score and PTT TTT FIB between the two groups (P 0.05). There were significant differences in hemoglobin and HCT between the two groups before and 1 day after operation, there was significant difference between the two groups (P 0.05), and there was interaction between the treatment method and the treatment time (P 0.05). Compared with the control group, the total blood loss, postoperative drainage, recessive blood loss and blood transfusion volume of the patients in the trial group were lower than those in the control group (P 0.05). The incisions of both groups were healed at the first stage, and no serious complications or adverse reactions were found. On the 7th day after operation, no venous thrombosis was found in both lower extremity venous color Doppler ultrasound. Conclusion Intra-articular injection of carbamoic acid combined with tube clipping for 3 hours can effectively reduce the blood loss after the first single knee arthroplasty without increasing the incidence of deep venous thrombosis of lower extremity. It is effective and safe.
【作者單位】： 安徽醫(yī)科大學附屬省立醫(yī)院骨2科;
【分類號】：R687.4

【共引文獻】

相關期刊論文 前10條

1 張俊;邵俊杰;蔣W，

本文編號：1999458