TKA后關(guān)節(jié)腔注入氨甲環(huán)酸與腎上腺素對(duì)患者出血及凝血功能的影響
發(fā)布時(shí)間:2018-06-08 04:35
本文選題:關(guān)節(jié)置換術(shù) + 膝關(guān)節(jié)。 參考:《山東醫(yī)藥》2017年32期
【摘要】:目的探討關(guān)節(jié)腔注入氨甲環(huán)酸與腎上腺素混合液對(duì)全膝關(guān)節(jié)置換術(shù)(TKA)后患者出血及凝血功能的影響。方法選擇初次行單側(cè)TKA患者64例,隨機(jī)分為觀察組和對(duì)照組,每組32例。兩組常規(guī)進(jìn)行TKA,術(shù)后留置引流管。觀察組通過(guò)引流管向關(guān)節(jié)腔內(nèi)注入含3.0 g氨甲環(huán)酸、0.25 mg腎上腺素的生理鹽水50 m L,對(duì)照組通過(guò)引流管向關(guān)節(jié)腔內(nèi)注入含3.0 g氨甲環(huán)酸的生理鹽水50 m L,兩組均夾閉引流管2 h。觀察兩組出血量(包括術(shù)中出血量、隱形出血量及總出血量)、術(shù)后引流量;兩組術(shù)前及術(shù)后24 h采用全自動(dòng)生化分析儀檢測(cè)血紅蛋白(Hb)、紅細(xì)胞壓積(PCV)、凝血酶原時(shí)間(PT)、活化的部分凝血活酶時(shí)間(APTT)。結(jié)果兩組術(shù)中出血量比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);觀察組隱性出血量、總出血量及術(shù)后引流量均低于對(duì)照組(P0.05或0.01)。與術(shù)前比較,兩組術(shù)后24 h Hb、PCV均降低,觀察組術(shù)后24 h PT升高(P均0.05);對(duì)照組術(shù)后24 h PT、APTT均較術(shù)前無(wú)明顯變化(P均0.05)。術(shù)后24 h,觀察組Hb、PCV均高于對(duì)照組(P均0.01),兩組PT、APTT比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論關(guān)節(jié)腔內(nèi)局部注入氨甲環(huán)酸與腎上腺素混合液可減少TKA患者術(shù)后出血,且對(duì)其凝血功能影響較小。
[Abstract]:Objective to investigate the effects of intraarticular injection of methacylic acid and epinephrine on bleeding and coagulation after total knee arthroplasty (TKA). Methods 64 patients with unilateral TKA were randomly divided into observation group and control group with 32 cases in each group. Two groups of routine TKA, postoperative indwelling drainage tube. In the observation group, 50 mL saline containing 0.25 mg epinephrine was injected into the articular cavity through the drainage tube, while the control group was injected into the articular cavity with 3.0 g normal saline containing 3.0 g methoxycycline. The drainage tubes were clamped for 2 h in both groups. The amount of blood loss (including intraoperative volume, invisible volume and total volume of bleeding) and postoperative drainage volume were observed in the two groups. Before operation and 24 hours after operation, the hemoglobin, hematocrit, prothrombin time and activated partial thromboplastin time (APTTT) were detected by automatic biochemical analyzer. Results there was no significant difference in the amount of intraoperative bleeding between the two groups (P 0.05), but the hidden bleeding, total bleeding and postoperative drainage in the observation group were lower than those in the control group (P0.05 or 0.01). Compared with those before operation, the PCV of the two groups decreased at 24 hours after operation, the PT of the observation group increased at 24 hours after operation (P < 0.05), and the APTT of the control group at 24 hours after operation was not significantly different from that of the control group (P < 0.05). 24 hours after operation, the PCV in the observation group was higher than that in the control group (P < 0.01), and there was no significant difference in APTT between the two groups (P < 0.05). Conclusion Intraarticular intraarticular injection of the mixture of carbamoic acid and epinephrine can reduce postoperative bleeding in TKA patients and has little effect on the coagulation function of TKA patients.
【作者單位】: 延邊大學(xué)附屬醫(yī)院;
【分類(lèi)號(hào)】:R687.4
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