【摘要】：目的觀察初次單側全膝關節(jié)置換術(TKA)中局部應用氨甲環(huán)酸的臨床效果。方法收集90例膝關節(jié)骨關節(jié)炎患者,隨機分為觀察組和對照組各45例,均行初次單側TKA治療。術中觀察組應用含氨甲環(huán)酸1 g/1 000 m L的生理鹽水沖洗關節(jié)腔,縫合關節(jié)囊后經引流管注入含1 g氨甲環(huán)酸的生理鹽水50 m L,術后夾閉3 h;對照組未使用氨甲環(huán)酸。術后測算兩組圍手術期的實際失血量、顯性失血量、隱性失血量、輸血量、輸血率,檢測術后第1、3、5天的血紅蛋白(Hb),觀察下肢瘀斑發(fā)生情況,術后第5天常規(guī)行下肢動靜脈超聲篩查有無深靜脈血栓形成(DVT)。結果與對照組比較,觀察組實際失血量、顯性失血量、隱性失血量、輸血量、輸血率及術后同時點Hb均低于對照組(P均0.05)。兩組DVT發(fā)生率比較差異無統(tǒng)計學意義,觀察組術后下肢瘀斑發(fā)生率低于對照組(P0.05)。結論初次單側TKA術中局部應用氨甲環(huán)酸,能減少患者顯性及隱性失血量,降低輸血量及輸血率,且不增加DVT的發(fā)生。
[Abstract]:Objective to observe the clinical effect of local application of carbamoic acid in primary unilateral total knee arthroplasty (TKA). Methods 90 cases of knee osteoarthritis were randomly divided into observation group (n = 45) and control group (n = 45). In the observation group, intraoperative saline containing 1 g / 1 000 mL of methocycline was used to wash the articular cavity, and 50 mL saline containing 1 g methocylic acid was injected into the joint capsule through the drainage tube after closure for 3 hours, while the control group was not treated with the methacylic acid. The actual blood loss, apparent blood loss, recessive blood loss, blood transfusion rate and hemoglobin (Hb), of the first 3 days after operation were measured to observe the occurrence of ecchymosis in the lower extremities of the two groups. On the 5th day after operation, the lower extremity arteriovenous ultrasound was routinely performed for the screening of deep venous thrombosis (DVT). Results compared with the control group, the actual amount of blood loss, the amount of dominant blood loss, the amount of recessive blood loss, the blood transfusion rate and the Hb at the same time after operation in the observation group were lower than those in the control group (all P 0.05). There was no significant difference in the incidence of DVT between the two groups. The incidence of ecchymosis in the observation group was lower than that in the control group (P0.05). Conclusion Local application of carbamoic acid in primary unilateral TKA can reduce the amount of dominant and recessive blood loss, decrease the amount of blood transfusion and blood transfusion rate, and do not increase the incidence of DVT.
【作者單位】： 勝利油田中心醫(yī)院;
【分類號】：R687.4

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