【摘要】：目的探討全髖關(guān)節(jié)置換術(shù)(THA)圍術(shù)期氨甲環(huán)酸全身與局部聯(lián)合應(yīng)用的臨床效果。方法選取初次擬行單側(cè)THA的股骨頭缺血性壞死患者60例,隨機(jī)分為局部組和聯(lián)合組,各30例。局部組分別于髖臼、股骨髓腔局部注射氨甲環(huán)酸0.5 g浸泡5 min,并經(jīng)引流管逆行灌注氨甲環(huán)酸0.5 g;聯(lián)合組在手術(shù)切皮前15 min靜滴氨甲環(huán)酸15 mg/kg,并采用與局部組同樣的方法進(jìn)行局部處理。記錄兩組術(shù)后6 h及12、24 d引流量,術(shù)前及術(shù)后1、3 d血紅蛋白(Hb)、紅細(xì)胞壓積(HCT),總出血量、輸血情況及術(shù)后深靜脈血栓形成(DVT)、肺栓塞(PE)發(fā)生情況。結(jié)果聯(lián)合組術(shù)后6 h及12、24 d引流量均低于局部組同時(shí)間點(diǎn)(P均0.05)。與術(shù)前比較,兩組術(shù)后1、3 d Hb、HCT均降低,但局部組降低更明顯(P均0.05)。聯(lián)合組總出血量及輸血率均低于局部組(P均0.05)。兩組術(shù)后均未發(fā)生DVT及PE。結(jié)論行THA患者術(shù)前氨甲環(huán)酸靜滴聯(lián)合術(shù)中髖臼及股骨髓腔局部注射、術(shù)后引流管逆行灌注可減少手術(shù)期出血,安全性高。
[Abstract]:Objective to investigate the clinical effect of total hip arthroplasty (tha) combined with local and systemic application of carbamoic acid during perioperative period. Methods 60 patients with avascular necrosis of femoral head were randomly divided into local group and combined group. The local group was located in acetabular, The femoral medullary cavity was soaked with methacylic acid 0.5 g for 5 minutes and retrograde instilled in the drainage tube for 0.5 g. The combined group was treated with the same method as the local group 15 mg 路kg ~ (-1) by intravenous drip 15 min before skin incision. Hemoglobin (HB), hematocrit (HCT), total blood loss, blood transfusion, deep venous thrombosis (DVT) and pulmonary embolism (PE) were recorded at 6 h and 12 h after operation in both groups, and hemoglobin (HB), hematocrit (HCT), blood transfusion, deep venous thrombosis (DVT) and pulmonary embolism (PE) were recorded before and after operation. Results the drainage volume in the combined group was lower than that in the local group at 6 h and 12 d after operation (P 0.05). Compared with pre-operation, HCT in both groups was decreased 1 and 3 days after operation, but the decrease in local group was more obvious (P 0.05). The total blood loss and blood transfusion rate in the combined group were lower than those in the local group (P 0.05). DVT and Pe were not found in both groups. Conclusion Local injection of acetabular and femoral medullary cavity and retrograde perfusion of drainage tube in patients with tha before operation can reduce bleeding during operation and is safe.
【作者單位】： 河南省洛陽正骨醫(yī)院河南省骨科醫(yī)院;
【分類號】：R687.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳艱;氨甲環(huán)酸在體外循環(huán)心臟手術(shù)中的應(yīng)用[J];江蘇醫(yī)藥;1997年03期

2 趙e鹒，

本文編號：2132174