【摘要】：目的探討氨甲環(huán)酸局部注射對初次單側(cè)全膝關(guān)節(jié)置換術(shù)后失血量的影響。方法采用隨機對照研究2013年12月-2016年08月在湖南省人民醫(yī)院關(guān)節(jié)外科因骨關(guān)節(jié)炎行單側(cè)初次關(guān)節(jié)置換術(shù)的60例患者,根據(jù)在關(guān)節(jié)腔關(guān)閉之前,關(guān)節(jié)囊局部是否注射氨甲環(huán)酸進行隨機分組,分為實驗組和對照組,各30例。實驗組:在關(guān)節(jié)腔關(guān)閉之前,關(guān)節(jié)囊局部注射10 ml(1.0 g)氨甲環(huán)酸并放置高負壓引流瓶;對照組:在關(guān)節(jié)腔關(guān)閉之前,關(guān)節(jié)囊囊壁周圍局部注射10 ml生理鹽水,同樣放置高負壓引流瓶。記錄兩組患者的術(shù)前血紅蛋白、術(shù)后引流量及術(shù)后第1、4及7天血紅蛋白和總失血量,并比較其術(shù)后輸血率、輸血量及發(fā)生深靜脈血栓的概率。結(jié)果實驗組術(shù)后24 h引流量、隱性失血量及總失血量均低于對照組,差異有統(tǒng)計學(xué)意義(P0.05);兩組患者術(shù)前血紅蛋白、紅細胞比容(HCT)比較,差異無統(tǒng)計學(xué)意義(P0.05),術(shù)后第1、4及7天血紅蛋白、HCT比較,實驗組均高于對照組,差異有統(tǒng)計學(xué)意義(P0.05);實驗組輸血率和接受輸血量均低于對照組,差異有統(tǒng)計學(xué)意義(P0.05);兩組患者術(shù)后深靜脈血栓發(fā)生率分別為16.7%及10%,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論高負壓引流基礎(chǔ)上聯(lián)合氨甲環(huán)酸局部注射可以降低單側(cè)初次全膝關(guān)節(jié)置換術(shù)后出血及輸血需求,并不增加深靜脈血栓的發(fā)生率。
[Abstract]:Objective to investigate the effect of local injection of carbamicylic acid on blood loss after primary unilateral total knee arthroplasty. Methods A randomized controlled study was conducted in 60 patients with osteoarthritis in the department of joint surgery of Hunan Provincial people's Hospital from December 2013 to August 2016. The articular capsule was randomly divided into experimental group (n = 30) and control group (n = 30). Experimental group: 10 ml (1.0 g) carbamoic acid was injected into the articular capsule before the closure of the articular cavity and the high negative pressure drainage bottle was placed in the control group: before the closure of the articular cavity, 10 ml normal saline was injected locally around the capsule wall of the joint. Also place a high negative pressure drain bottle. The preoperative hemoglobin, postoperative drainage volume, hemoglobin and total blood loss were recorded, and the blood transfusion rate, blood transfusion volume and the probability of deep venous thrombosis were compared between the two groups. Results 24 hours after operation, the volume of recessive blood loss and total blood loss in the experimental group were significantly lower than those in the control group (P0.05), the hemoglobin and erythrocyte specific volume (HCT) were compared between the two groups before operation. There was no significant difference (P0.05). The HCT in the experimental group was higher than that in the control group on the 4th and 7th day after operation (P0.05); the blood transfusion rate and the volume of blood transfusion in the experimental group were lower than those in the control group. The difference was statistically significant (P0.05); the incidence of deep venous thrombosis in the two groups was 16.7% and 10% respectively, the difference was not statistically significant (P0.05). Conclusion Local injection of carbamate on the basis of high negative pressure drainage can reduce bleeding and blood transfusion demand after unilateral primary total knee arthroplasty without increasing the incidence of deep venous thrombosis.
【作者單位】： 湖南省人民醫(yī)院關(guān)節(jié)外科;南華大學(xué);
【分類號】：R687.4

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