本文選題：關(guān)節(jié)成形術(shù) + 置換　； 參考：《中國(guó)全科醫(yī)學(xué)》2015年06期

【摘要】：目的探討采用關(guān)節(jié)內(nèi)注射氨甲環(huán)酸聯(lián)合引流管夾閉3 h方案減少初次單膝關(guān)節(jié)置換術(shù)患者圍術(shù)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(xué)附屬省立醫(yī)院骨科行單側(cè)首次全膝關(guān)節(jié)置換術(shù)的老年患者90例(90膝),采用隨機(jī)數(shù)字表法將患者分為試驗(yàn)組與對(duì)照組,每組45例�；颊呔晟菩g(shù)前常規(guī)檢查,同時(shí)行雙下肢靜脈彩超,試驗(yàn)組于手術(shù)關(guān)閉筋膜層后關(guān)節(jié)內(nèi)注射氨甲環(huán)酸并夾閉引流管3 h,對(duì)照組關(guān)節(jié)內(nèi)注射20 ml 0.9%氯化鈉溶液并維持引流管開(kāi)放,兩組患者引流管均于術(shù)后48 h拔除。記錄術(shù)前兩組患者年齡、性別、左/右側(cè)、體質(zhì)指數(shù)、手術(shù)時(shí)間、美國(guó)麻醉師協(xié)會(huì)(ASA)評(píng)分、凝血酶原時(shí)間(PT)、活化部分凝血活酶時(shí)間(APTT)、纖維蛋白原(FIB)水平,術(shù)前及術(shù)后1、3 d血紅蛋白及血細(xì)胞比容(HCT),總失血量、術(shù)后引流量、隱性失血量、輸血量。結(jié)果兩組患者年齡、性別、左/右側(cè)、體質(zhì)指數(shù)、手術(shù)時(shí)間、ASA評(píng)分、PT、APTT、FIB水平比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者術(shù)前及術(shù)后1、3 d血紅蛋白及HCT比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);治療方法與治療時(shí)間存在交互作用(P0.05)。試驗(yàn)組患者術(shù)后總失血量、術(shù)后引流量、隱性失血量、輸血量較對(duì)照組均減少(P0.05)。兩組患者的手術(shù)切口均一期愈合,且均未出現(xiàn)嚴(yán)重并發(fā)癥和不良反應(yīng),術(shù)后第7天復(fù)查雙下肢靜脈彩超均未發(fā)現(xiàn)靜脈血栓。結(jié)論關(guān)節(jié)內(nèi)注射氨甲環(huán)酸聯(lián)合引流管夾閉3 h方案可有效減少初次單膝關(guān)節(jié)置換術(shù)后的血液丟失,同時(shí)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(xué)附屬省立醫(yī)院骨2科;
【分類號(hào)】：R687.4

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張俊;邵俊杰;蔣W，

本文編號(hào)：1999458