發(fā)布時間：2018-06-21 22:14

  本文選題：氨甲環(huán)酸 + 全膝關(guān)節(jié)置換�。� 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:將氨甲環(huán)酸的三種不同使用方式應(yīng)用在全膝關(guān)節(jié)置換術(shù)中,通過對比三組術(shù)后的止血療效和安全性,探究出氨甲環(huán)酸在全膝關(guān)節(jié)置換中的最佳應(yīng)用方式。方法:采用前瞻性病例對照研究方法,通過記錄患者的統(tǒng)計學(xué)資料、術(shù)前血液數(shù)據(jù)、術(shù)后失血量、血紅蛋白值、術(shù)后并發(fā)癥、輸血率及發(fā)生血栓事件的概率。納入我院2015年1月-2016年12月共124位接受單側(cè)膝關(guān)節(jié)置換術(shù)的患者,將124位患者隨機分配成3組,分別是局部組、聯(lián)合組、靜脈組,氨甲環(huán)酸的劑量為15mg/kg。靜脈組:松開止血帶之前15分鐘開始靜脈滴注15mg/kg劑量氨甲環(huán)酸;局部組:縫合關(guān)節(jié)腔后通過引流管逆行注射15mg/kg氨甲環(huán)酸;聯(lián)合組:松止血帶前15分鐘開始靜脈滴注15mg/kg氨甲環(huán)酸一半的劑量,并在縫合關(guān)節(jié)腔后通過引流管逆行注射15mg/kg氨甲環(huán)酸的另一半劑量。三組患者術(shù)前一般資料、凝血功能指標進行比較差異均無統(tǒng)計學(xué)意義(P均0.05)。比較總失血量、術(shù)后24引流量、隱性失血量、血紅蛋白值、血紅蛋白丟失量、VTE事件。結(jié)果:三組術(shù)后24h引流量差異無統(tǒng)計學(xué)差異,P0.05;聯(lián)合組總失血量、隱性失血量、血紅蛋白丟失量均明顯低于靜脈組和局部組,差異有統(tǒng)計學(xué)意義,P0.05;靜脈組和局部組中各有4人術(shù)后出現(xiàn)小腿肌間靜脈血栓,聯(lián)合組中有2位患者術(shù)后出現(xiàn)小腿肌間靜脈血栓,差異無統(tǒng)計學(xué)意義,P0.05;三組患者術(shù)后均未出現(xiàn)肺栓塞。結(jié)論:三組在全膝關(guān)節(jié)置換中聯(lián)合組更能減少血紅蛋白丟失量、總失血量及隱性失血量;三組術(shù)后三個月內(nèi)VTE發(fā)生率差異無統(tǒng)計學(xué)意義。
[Abstract]:Objective: to explore the best application of tranexamic acid in total knee arthroplasty by comparing the hemostatic effect and safety of the three groups. Methods: a prospective case-control study was conducted to record the patient's statistical data, preoperative blood data, postoperative blood loss, hemoglobin value, postoperative complications, blood transfusion rate and probability of thrombotic events. From January 2015 to December 2016, 124 patients underwent unilateral knee arthroplasty in our hospital. 124 patients were randomly divided into three groups: local group, combined group, intravenous group, and methacylic acid (15 mg / kg). Intravenous group: 15mg/kg was injected intravenously 15 minutes before release of tourniquet, local group: 15mg/kg was injected retrograde through drainage tube after joint cavity was sutured. In the combined group, half of 15mg/kg was injected intravenously 15 minutes before the tourniquet and the other half of 15mg/kg was injected retrograde through the drainage tube after the joint cavity was sutured. There was no significant difference in preoperative general data and coagulation function between the three groups (P 0.05). Total blood loss, 24 drainage, recessive blood loss, hemoglobin value and hemoglobin loss were compared with VTE events. Results: there was no significant difference in the volume of blood loss, recessive blood loss and hemoglobin loss between the three groups 24 hours after operation (P 0.05), and the total blood loss, recessive blood loss and hemoglobin loss in the combined group were significantly lower than those in the venous group and the local group. The difference was statistically significant (P 0.05), there were 4 patients in the vein group and 4 patients in the local group, and 2 patients in the combined group developed intermuscular vein thrombosis of the leg after operation. There was no significant difference (P 0.05). No pulmonary embolism was found in the three groups. Conclusion: the combined group can reduce the amount of hemoglobin loss, total blood loss and recessive blood loss in total knee arthroplasty, but there is no significant difference in the incidence of VTE in the three groups within three months after operation.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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相關(guān)期刊論文 前1條

1 傅德杰;陳凱寧;楊柳;;氨甲環(huán)酸對全膝關(guān)節(jié)置換術(shù)失血量影響的系統(tǒng)評價[J];中國矯形外科雜志;2012年13期

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本文編號：2050230