局部应用氨甲环酸对PFNA围手术期隐形失血疗效的研究

发布时间：2018-01-16 03:06

本文关键词：局部应用氨甲环酸对PFNA围手术期隐形失血疗效的研究　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨局部应用氨甲环酸对股骨PFNA手术隐形失血疗效及安全性的研究。方法:回顾性分析了我科于2014年02月01日至2016年11月30日期间诊治的132例采用PFNA治疗的老年股骨转子间骨折患者的临床资料。根据局部应用氨甲环酸的情况分为氨甲环酸组和对照组。记录患者术前(入院当天)与术后第5日的血红蛋白(Hb)和红细胞压积(Hct);记录围手术期的显性失血量,采用Cross线性方程计算总出血量和隐性出血量。于手术前及术后第5天分别行双下肢血管彩超检查,对比以了解有无血栓形成及相关并发症情况,评价氨甲环酸应用的安全性。结果:围手术期总失血量:氨甲环酸组573.61±92.8ml,对照组806.29±98.43ml;隐性失血量:氨甲环酸组469.76±89.27ml,占总失血量的81.9%,对照组680.69±90.81ml,占总失血量的84.4%;术后患者输血情况:氨甲环酸组12例,占17.65%,对照组21例,占32.81%。两组术前血红蛋白(Hb)比较差异无统计学意义(P0.05),Hct变化量及输血例数氨甲环酸组均明显低于对照组,差异有统计学意义(P0.05);围手术期总的理论失血量、隐性失血量TXA组均明显低于对照组,差异有统计学意义(P0.05);两组显性失血量比较差异无统计学意义(P0.05);而所有132例患者双下肢均无血栓形成,无血栓相关疾病病例出现。结论:对于老年股骨转子间骨折患者,局部应用氨甲环酸可明显减少围手术期总失血量和隐性失血量,并不增加血栓形成及其相关疾病的发生风险。
[Abstract]:Objective: to investigate the efficacy and safety of local application of carbamicylic acid in the treatment of stealthy blood loss in PFNA operation. The clinical data of 132 elderly patients with intertrochanteric fracture of femur treated with PFNA from February 1st 2014 to November 30th 2016 were analyzed retrospectively. The patients were divided into two groups: the control group and the control group. The hemoglobin (HB) and hematocrit (HCT) were observed on the first day of admission and on 5th after operation. The dominant blood loss was recorded during perioperative period and the total and recessive blood loss was calculated by Cross linear equation. The blood vessels of both lower limbs were examined by color Doppler ultrasonography before operation and 5 days after operation. Results: total blood loss in perioperative period was 573.61 卤92.8ml. The control group was 806.29 卤98.43 ml; Recessive blood loss was 469.76 卤89.27mlin group, accounting for 81.9 ml of total blood loss, and 680.69 卤90.81 ml in control group, accounting for 84.4ml of total blood loss. The blood transfusion status of the patients after operation: 12 cases (17.65%) in the carbamicylic acid group and 21 cases in the control group. There was no significant difference between the two groups in the changes of HCT and the number of transfusions of HCT in the two groups, which were significantly lower than those in the control group. The difference was statistically significant (P 0.05). The total theoretical blood loss and recessive blood loss in the TXA group were significantly lower than those in the control group in perioperative period (P 0.05). There was no significant difference in the amount of dominant blood loss between the two groups (P 0.05). All 132 patients had no thrombosis in both lower extremities and no thrombotic related diseases. Conclusion: for the elderly patients with intertrochanteric fracture of femur. Local application of carbonic acid can significantly reduce the total and recessive blood loss in perioperative period, and does not increase the risk of thrombosis and related diseases.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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