本文選題：氨甲環(huán)酸　切入點(diǎn)：藥物療法　出處：《中國(guó)骨與關(guān)節(jié)雜志》2016年12期 　論文類(lèi)型：期刊論文

【摘要】：目的探討氨甲環(huán)酸應(yīng)用方式對(duì)人工全膝關(guān)節(jié)置換術(shù)后失血量的影響,并進(jìn)行安全性評(píng)估。方法選取2015年3月至2016年7月符合納入標(biāo)準(zhǔn)需行單側(cè)全膝關(guān)節(jié)置換術(shù)的78例,按照區(qū)組隨機(jī)法,分為A組、B組、C組,A組在止血帶解除前10 min給予氨甲環(huán)酸溶液100 ml靜滴(氨甲環(huán)酸1 g)。B組在止血帶釋放前假體植入后,切口內(nèi)予氨甲環(huán)酸溶液100 ml(氨甲環(huán)酸1 g)浸泡5 min。C組縫合關(guān)節(jié)囊后通過(guò)引流管注入關(guān)節(jié)腔氨甲環(huán)酸溶液100 ml(氨甲環(huán)酸1 g),臨時(shí)夾閉引流管2 h。比較3組術(shù)中出血量、隱性失血量、總失血量、術(shù)后總引流量、術(shù)后血紅蛋白水平、輸血情況及不良反應(yīng)發(fā)生情況。結(jié)果術(shù)中失血量:A組(134.88±12.12)ml、B組(131.19±11.02)ml、C組(132.85±10.21)ml,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.490.05);術(shù)后總引流量:A組(252.27±57.42)ml、B組(208.14±38.62)ml、C組(158.5±20.70)ml,B組、C組低于A組(P=0.000.05);隱性失血量:A組(351.03±89.87)ml、B組(288.96±67.13)ml、C組(180.26±31.33)ml,B組、C組低于A組(P=0.000.05);總失血量:A組(550.65±87.91)ml、B組(458.12±77.30)ml、C組(366.89±70.69)ml,B組、C組低于A組(P=0.000.05)。術(shù)后12、24、48 h血紅蛋白減少量平均值:A組(24.62±3.51)g/L、B組(21.84±2.81)g/L、C組(17.43±2.24)g/L,B組、C組低于A組(P=0.000.05);術(shù)后輸血病例A組4例、B組5例、C組2例,輸血量B、C組小于A組(P=0.020.05)。3組均無(wú)術(shù)后感染、肺栓塞及下肢深靜脈血栓形成等并發(fā)癥發(fā)生。結(jié)論在全膝關(guān)節(jié)置換術(shù)中氨甲環(huán)酸應(yīng)用方式與術(shù)后失血量有明顯的相關(guān)性,局部關(guān)節(jié)腔注射止血效果優(yōu)于靜脈輸液、局部浸泡。
[Abstract]:Objective to investigate the effect of methionine on blood loss after total knee arthroplasty (TKA) and to evaluate its safety. Methods 78 cases of unilateral total knee arthroplasty were selected from March 2015 to July 2016. According to the block method, group A was divided into two groups: group A, group B, group C, group C, group A: 10 min before release of tourniquet, group A were given 100ml intravenous drip of carbamate solution 10 min before release of tourniquet (group B) after implantation of prosthesis before release of tourniquet. The joint capsule was sutured with 100ml of methacylic acid solution (1 g of methacylic acid) for 5 min.C, and then injected into the articular cavity of 100 ml (1 g of ammonia acid) through drainage tube for 2 h. The amount of blood lost in the three groups was compared. Recessive blood loss, total blood loss, postoperative drainage, postoperative hemoglobin level, Results the volume of blood loss in group A was 134.88 鹵12.12ml / ml in group B 131.19 鹵11.02ml / L group C was 132.85 鹵10.21ml / ml, the difference was not statistically significant (P = 0.490.05), and the total postoperative drainage volume was 252.27 鹵57.42ml / ml group B group (208.14 鹵38.62ml / L) group C group (158.5 鹵20.70ml / L) group C was lower than group A (P 0.000.05), and the recessive blood loss volume in group A (351.03 鹵89.87ml / ml) group B group (288.96 鹵67.13ml / ml) was 180.26 鹵31.26 鹵31.26 鹵31.26 鹵31.26 鹵31.26 鹵38.26 鹵31.26 鹵38.26 鹵31.26 鹵38.26 鹵38.62ml / ml respectively. The total blood loss of group A was 550.65 鹵87.91ml / L group 458.12 鹵77.30ml / ml group (366.89 鹵70.69ml / ml) was lower than that of group A P0.000.055.The average of hemoglobin reduction at 1224244h in group A was 24.62 鹵3.51g / L = 21.84 鹵2.81g / L = 21.84 鹵2.81g / L respectively. There was no postoperative infection, pulmonary embolism and deep venous thrombosis of lower extremity in group B C less than group A (P 0.020.053.Conclusion there was a significant correlation between the application of methionine in total knee arthroplasty and the amount of blood loss after operation. The hemostatic effect of local articular cavity injection was better than that of intravenous infusion and local immersion.
【作者單位】： 陜西中醫(yī)藥大學(xué)第二附屬醫(yī)院;核工業(yè)二一五醫(yī)院;
【分類(lèi)號(hào)】：R687.4

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