本文選題：全膝關(guān)節(jié)置換術(shù)　切入點(diǎn)：氨甲環(huán)酸　出處：《中國(guó)現(xiàn)代醫(yī)學(xué)雜志》2017年22期

【摘要】：目的比較全膝關(guān)節(jié)置換術(shù)中靜脈給予氨甲環(huán)酸和關(guān)節(jié)腔內(nèi)注射氨甲環(huán)酸減少出血及降低輸血率的有效性。方法 80例因膝關(guān)節(jié)骨關(guān)節(jié)炎行全膝關(guān)節(jié)置換患者隨機(jī)分為兩組:靜脈注射氨甲環(huán)酸組(1組)和關(guān)節(jié)腔注射氨甲環(huán)酸組(2組)。1組分別在術(shù)前、術(shù)中、術(shù)后靜脈注射氨甲環(huán)酸3次。2組是在止血帶放松前,將3 g氨甲環(huán)酸用生理鹽水稀釋成100 ml溶液,注入關(guān)節(jié)腔內(nèi)。術(shù)后觀察24和48 h的引流量及48 h內(nèi)的總引流量,術(shù)后48 h血紅蛋白量,同時(shí)監(jiān)測(cè)輸血及血栓情況。結(jié)果所有膝關(guān)節(jié)置換手術(shù)均順利完成,無(wú)感染、壞死、脂肪液化發(fā)生。1組48 h的平均引流量是(409.5±185.8)ml,平均血紅蛋白的下降值是(2.42±0.86)mg/dl,2組48 h的平均引流量是(386.5±89.1)ml,平均血紅蛋白的下降值是(2.21±0.64)mg/dl。兩組間的引流量和血紅蛋白下降值比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。其中1組有3例患者,2組有4例患者需要輸血。術(shù)后14 d行雙下肢彩色多普勒超聲檢查,均未發(fā)現(xiàn)有靜脈血栓形成。結(jié)論對(duì)于減少全膝關(guān)節(jié)置換術(shù)術(shù)中出血,關(guān)節(jié)腔內(nèi)注射氨甲環(huán)酸的作用等同于通過(guò)靜脈給予3次氨甲環(huán)酸所起到的作用。
[Abstract]:Objective to compare the efficacy of intravenous and intraarticular injection of carbamate in total knee arthroplasty to reduce bleeding and blood transfusion rate.Methods 80 patients with knee osteoarthritis underwent total knee arthroplasty were randomly divided into two groups: group 1 with intravenous methocycline (group 1) and group 1 with intraarticular injection (group 1).Before the tourniquet was relaxed, the 3 g carbamate was diluted into 100ml solution with normal saline and injected into the articular cavity.There was no significant difference between the two groups in the drainage flow and the decrease of hemoglobin (P 0.05).There were 3 patients in group 1 and 4 patients in group 2 needed blood transfusion.On the 14th day after operation, no venous thrombosis was found in both lower extremities by color Doppler ultrasonography.Conclusion the effect of intraarticular injection of carbamoic acid on reducing bleeding in total knee arthroplasty is the same as that of intravenous injection of trimethoic acid.
【作者單位】： 山東省壽光市人民醫(yī)院關(guān)節(jié)創(chuàng)傷外科;
【分類(lèi)號(hào)】：R687.4

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