發(fā)布時(shí)間：2018-07-03 10:57

  本文選題：氨甲苯酸 + 局部用藥��； 參考：《廣西中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察氨甲苯酸創(chuàng)腔局部用藥對(duì)全髖關(guān)節(jié)置換術(shù)后出血的影響,評(píng)價(jià)氨甲苯酸的止血的有效性及安全性。方法:本研究采取前瞻性隨機(jī)對(duì)照研究,選取2014.1~2016.1符合入選要求的90例行單側(cè)初次全髖關(guān)節(jié)置換術(shù)的患者,其中男55例,女35例,根據(jù)術(shù)后創(chuàng)腔不同用藥隨機(jī)分為三組:A組30例,將氨甲苯酸注射液(10ml:0.1g),3支溶于20ml生理鹽水中,在關(guān)閉切口后經(jīng)引流管逆行推注入關(guān)節(jié)腔,B組30例,將氨甲環(huán)酸粉針(0.5g)2支溶于50ml生理鹽水中,在關(guān)閉切口后經(jīng)引流管逆行推注入關(guān)節(jié)腔,C組30例將50ml生理鹽水,在關(guān)閉切口后經(jīng)引流管逆行推注入關(guān)節(jié)腔。三組術(shù)后均夾閉引流管4小時(shí)。統(tǒng)計(jì)各組患者的術(shù)后48小時(shí)引流量、輸血人數(shù)、術(shù)后第一天和第三天血紅蛋白及紅細(xì)胞壓積值等評(píng)價(jià)指標(biāo),以觀察氨甲苯酸注射液止血效果。結(jié)果:入選90例患者均完成了整個(gè)治療過(guò)程,無(wú)一例脫落。術(shù)前三組患者在性別、年齡、身高、體重、體重指數(shù)、病種、術(shù)前血紅蛋白及紅細(xì)胞壓積指標(biāo)比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性;術(shù)后引流量、輸血人數(shù)A組和B組都小于C組(P0.05),A組和B組在輸血人數(shù)、術(shù)后血紅蛋白及紅細(xì)胞壓積方面無(wú)明顯差異(P0.05)。三組患者均未出現(xiàn)雙下肢深靜脈血栓及肺栓塞。結(jié)論:氨甲苯酸創(chuàng)腔局部用藥能明顯降低全髖關(guān)節(jié)置換術(shù)后引流量及輸血人數(shù),氨甲苯酸和氨甲環(huán)酸二者在減少全髖關(guān)節(jié)置換術(shù)后引流量及輸血人數(shù)上影響水平相當(dāng),而且并未增加下肢深靜脈血栓和肺栓塞形成的風(fēng)險(xiǎn)。氨甲苯酸價(jià)格低廉、創(chuàng)腔局部用藥安全性高,是值得推廣的一種止血方式。
[Abstract]:Objective: to observe the effect of local administration of aminomethylbenzoic acid on bleeding after total hip arthroplasty and to evaluate the efficacy and safety of aminobenzoic acid in hemostasis. Methods: a prospective randomized controlled study was conducted in which 90 patients (55 males and 35 females) with unilateral primary total hip arthroplasty were randomly divided into three groups according to the different drugs used in the invasive cavity: group A (30 cases), and group A (30 cases). Three branches of aminomethylbenzoic acid injection (10ml:0.1g) were dissolved in 20ml saline. After closing the incision, 30 cases of group B were retrogradely injected with drainage tube after closure of the incision. Two of them (0.5 g) were dissolved in normal saline of 50ml. After closing the incision, 30 patients in group C were injected with 50ml normal saline retrograde through drainage tube, and then retrograde pushed into the joint cavity by drainage tube after closure of incision. The drainage tubes were clamped for 4 hours after operation in all three groups. In order to observe the hemostatic effect of aminobenzoic acid injection, the drainage flow, the number of blood transfusion, hemoglobin and hematocrit on the first day and the third day after operation were calculated and analyzed in order to observe the hemostatic effect of aminobenzoic acid injection. Results: 90 patients completed the whole course of treatment, none of them dropped off. There was no significant difference in sex, age, height, body mass index, disease, hemoglobin and hematocrit between the three groups before operation (P0.05). The number of blood transfusion in group A and group B was lower than that in group C (P0.05). There was no significant difference in the number of blood transfusion, hemoglobin and hematocrit after operation (P0.05). No deep venous thrombosis and pulmonary embolism were found in the three groups. Conclusion: local administration of aminomethylbenzoic acid can significantly reduce the drainage volume and the number of blood transfusions after total hip arthroplasty. The effect of aminomethylbenzoic acid and aminomethacin on the volume of drainage and the number of blood transfusions after total hip replacement is the same. There was no increased risk of deep venous thrombosis and pulmonary embolism in the lower extremities. Aminobenzoic acid is a kind of hemostatic method worth popularizing because of its low price and high safety.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R274.9

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