氨甲環(huán)酸序貫利伐沙班在全髖關(guān)節(jié)置換圍手術(shù)期有效性與安全性研究
發(fā)布時間：2018-07-24 19:56
【摘要】：目的探索全髖關(guān)節(jié)置換術(shù)(THA)應(yīng)用氨甲環(huán)酸后序貫應(yīng)用利伐沙班的有效性與安全性。方法根據(jù)隨機(jī)對照原則設(shè)計,選取2012年9月～2015年6月擬初次單側(cè)THA患者150例。隨機(jī)分為A、B、C、D、E共5組,每組30例。A組患者不使用氨甲環(huán)酸,B組患者在切皮前10mins予10mg/kg氨甲環(huán)酸靜滴,C組患者在切皮前10mins予15mg/kg氨甲環(huán)酸靜滴,D組患者在切皮前10mins及3h后分別予15mg/kg氨甲環(huán)酸靜滴,E組患者在切皮前10mins予15mg/kg氨甲環(huán)酸靜滴,關(guān)閉切口前再予1g氨甲環(huán)酸關(guān)節(jié)腔局部浸泡使用。術(shù)后6h引流量30ml/h時給予利伐沙班10mmg口服,以后按常規(guī)劑量使用至術(shù)后35d。觀察A、B、C、D、E這5組患者術(shù)中出血量、術(shù)后引流量、總失血量、輸血率、術(shù)后第1天凝血酶原時間(PT)、部分活化凝血活酶時間(APTT)、拔除引流管后血紅蛋白(Hb)下降值的差異及術(shù)后深靜脈血栓(DVT)及肺栓塞(PE)的發(fā)生率。結(jié)果五組患者術(shù)中出血量、術(shù)后引流量、總失血量、輸血率、拔管后Hb下降值差異具有統(tǒng)計學(xué)意義(P0.05)。所有患者圍手術(shù)期及術(shù)后1個月、3個月門診隨訪均未發(fā)生DVT及PE。結(jié)論THA圍手術(shù)期應(yīng)用氨甲環(huán)酸后序貫應(yīng)用利伐沙班是安全、有效的,切皮前10mins及3h后分別予15mg/kg氨甲環(huán)酸靜滴對減少THA圍手術(shù)期失血量的療效最為顯著。
[Abstract]:Objective to explore the effectiveness and safety of the sequential application of Lev Shaaban after total hip replacement (THA). Methods according to the random control principle, 150 cases of first unilateral THA from September 2012 to June 2015 were selected and randomly divided into 5 groups of A, B, C, D, E, and 30 patients in each group did not use methicyclic acid, and the patients in group B were in the skin. The anterior 10mins was given to 10mg/kg methicate, and the patients in group C were intravenous drip of 15mg/kg methicate before cutting the skin, and the patients in group D were intravenous drip of 15mg/kg methicate after 10mins and 3H before the skin incision. The E group was given 15mg/kg ammonia methicate before cutting the skin and closed to the incision before closing the incision. The flow rate of 30ml/h was given to LEV Shaaban 10mmg orally, and then the 5 groups of patients with A, B, C, D, E were used to observe the amount of bleeding during the operation, the postoperative flow rate, the total blood loss, the blood transfusion rate, the first day thrombin time (PT) after operation, and the difference in the reduction of hemoglobin (Hb) after removal of the drainage tube after the operation. Results the incidence of posterior deep venous thrombosis (DVT) and pulmonary embolism (PE). Results there were significant differences in the amount of intraoperative bleeding, postoperative flow rate, total blood loss, blood transfusion rate, and Hb decline after extubation (P0.05). All patients in the perioperative period and 1 months after the operation, and 3 months of 3 month follow-up, did not have DVT and PE. in the perioperative period of the application of methylene rings in the perioperative period of THA operation. The sequential application of Lev Shaaban after acid after acid is safe and effective. The effect of 15mg/kg methicate acid intravenous drip before 10mins and 3H before skin resection is the most effective for reducing the blood loss in the perioperative period of THA.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R687.4
[Abstract]:Objective to explore the effectiveness and safety of the sequential application of Lev Shaaban after total hip replacement (THA). Methods according to the random control principle, 150 cases of first unilateral THA from September 2012 to June 2015 were selected and randomly divided into 5 groups of A, B, C, D, E, and 30 patients in each group did not use methicyclic acid, and the patients in group B were in the skin. The anterior 10mins was given to 10mg/kg methicate, and the patients in group C were intravenous drip of 15mg/kg methicate before cutting the skin, and the patients in group D were intravenous drip of 15mg/kg methicate after 10mins and 3H before the skin incision. The E group was given 15mg/kg ammonia methicate before cutting the skin and closed to the incision before closing the incision. The flow rate of 30ml/h was given to LEV Shaaban 10mmg orally, and then the 5 groups of patients with A, B, C, D, E were used to observe the amount of bleeding during the operation, the postoperative flow rate, the total blood loss, the blood transfusion rate, the first day thrombin time (PT) after operation, and the difference in the reduction of hemoglobin (Hb) after removal of the drainage tube after the operation. Results the incidence of posterior deep venous thrombosis (DVT) and pulmonary embolism (PE). Results there were significant differences in the amount of intraoperative bleeding, postoperative flow rate, total blood loss, blood transfusion rate, and Hb decline after extubation (P0.05). All patients in the perioperative period and 1 months after the operation, and 3 months of 3 month follow-up, did not have DVT and PE. in the perioperative period of the application of methylene rings in the perioperative period of THA operation. The sequential application of Lev Shaaban after acid after acid is safe and effective. The effect of 15mg/kg methicate acid intravenous drip before 10mins and 3H before skin resection is the most effective for reducing the blood loss in the perioperative period of THA.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R687.4
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