【摘要】：目的:觀察初次人工全膝關(guān)節(jié)置換術(shù)后應(yīng)用低分子肝素抗凝對(duì)失血量的影響。方法:自2013年09月~2014年10月,山東中醫(yī)藥大學(xué)附屬醫(yī)院骨關(guān)節(jié)科接受Link Gemini MKⅡ人工膝關(guān)節(jié)假體人工全膝關(guān)節(jié)置換的72例初次進(jìn)行膝關(guān)節(jié)置換的患者,其中男20例,女52例;年齡50到78歲,平均64.31士7.34歲,隨機(jī)分成兩組(治療組、對(duì)照組)。術(shù)前查血常規(guī)、血生化、凝血功能等,記錄血紅蛋白及紅細(xì)胞壓積,術(shù)中記錄出血量、輸血量。術(shù)后刀口內(nèi)放置引流管兩根,接一個(gè)自體血回輸器。根據(jù)患者術(shù)后6小時(shí)內(nèi)引流量進(jìn)行自體血回輸,6小時(shí)后治療組患者應(yīng)用低分子肝素(萬(wàn)脈舒)Q12H抗凝,對(duì)照組患者術(shù)后應(yīng)用低分子肝素(萬(wàn)脈舒)QD抗凝,其他術(shù)后治療及處理均相同,48小時(shí)后復(fù)查血常規(guī)記錄血紅蛋白及紅細(xì)胞壓積,根據(jù)記錄數(shù)據(jù)計(jì)算出總失血量、顯性失血量、隱性失血量。結(jié)果:治療組36例和對(duì)照組36例患者圍手術(shù)期失血量情況進(jìn)行統(tǒng)計(jì)分析,得出治療組患者與對(duì)照組患者圍手術(shù)期總失血量分別為:844.58士211.27(ml)和719.36士279.26(ml),P=0.0350.05。即:兩組間差異有統(tǒng)計(jì)學(xué)意義。兩組患者顯性失血量分別是577.36士177.65(ml)和482.78士187.6(ml),P=0.0310.05,兩組間差異有統(tǒng)計(jì)學(xué)意義。對(duì)隱性失血量進(jìn)行分析得出結(jié)果,分別為267.22(ml)士145.36和236.58士145.63(ml),通過(guò)比較分析兩組P=0.375㧐0.05,即:兩組間差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:應(yīng)用低分子肝素鈣(萬(wàn)脈舒)增加用量的同時(shí)也增加了術(shù)后的失血量。
[Abstract]:Objective: to observe the effect of low molecular weight heparin anticoagulant on blood loss after primary total knee arthroplasty. Methods: from September 2013 to October 2014, 72 patients, including 20 males and 52 females, aged from 50 to 78 years (mean 64.31 鹵7.34 years old), underwent total knee arthroplasty with Link Gemini MK II artificial knee arthroplasty in the affiliated Hospital of Shandong University of traditional Chinese Medicine. They were randomly divided into two groups (treatment group, control group). Blood routine, blood biochemistry, coagulation function, hemoglobin and hematocrit were recorded before operation, and blood loss and transfusion were recorded during operation. After operation, two drainage tubes were placed in the knife edge, followed by an autologous blood transfusion device. The patients in the treatment group were treated with low molecular weight heparin (Wanmashu) Q12H anticoagulant within 6 hours after operation, and the patients in the control group were treated with low molecular weight heparin (Wameshu) Q12H anticoagulant within 6 hours after operation. The other treatment and treatment were the same. Hemoglobin and hematocrit were recorded by blood routine examination 48 hours later, and the total blood loss, dominant blood loss and hidden blood loss were calculated according to the recorded data. Results: the perioperative blood loss of 36 patients in the treatment group and 36 patients in the control group were statistically analyzed. The results showed that the total blood loss in the treatment group and the control group were 844.58 鹵211.27 (ml) and 719.36 鹵279.26 (ml), P 鈮，

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