氨甲环酸对腰椎后路椎间融合术出血量的影响

发布时间：2018-03-29 04:30

本文选题：氨甲环酸　切入点：用药方法　出处：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨静脉及局部两种用药方法对腰椎后路椎间融合术出血量的影响。方法:选取2015年12月至2016年12月在中国人民解放军新疆军区总医院行腰椎后路椎间融合术患者90例,随机分配为3组:局部组术中缝合前创口内撒入1g氨甲环酸粉剂,共计30例(A组);静脉组将1 g氨甲环酸粉剂配入100 ml生理盐水中,手术切皮前15 min静脉滴注,共计30例(B组);空白组术中不使用氨甲环酸,共计30例(C组);两种用药方法分别与空白组比较围手术期总失血量、显性失血量、术后72h隐性失血量、凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-Dimer)]的变化。结果:静脉用药组和空白组相比,围手术期总失血量、显性失血量、术后72h隐性失血量、凝血功能均无统计学意义(P0.05);局部用药组和空白组相比围手术期总失血量、显性失血量、术后72h隐性失血量均明显低于空白组(P0.05),两组凝血功能相比无统计学意义(P0.05);局部用药组和静脉用药组相比围手术期总失血量、显性失血量、术后72h隐性失血量均明显低于静脉用药组(P0.05),两组凝血功能相比无统计学意义(P0.05)。结论:后路腰椎椎间融合术局部应用氨甲环酸可明显减少围手术期总失血量、显性失血量、术后72h隐性失血量。静脉小剂量使用氨甲环酸对围手术总失血量、显性失血量及术后72h隐性失血量无明显影响。
[Abstract]:Objective: to investigate the effect of intravenous and local drug therapy on the blood loss of lumbar posterior interbody fusion. Methods: 90 cases of posterior lumbar interbody fusion were performed from December 2015 to December 2016 in Xinjiang military region Hospital of Chinese people's Liberation Army (PLA). Three groups were randomly divided into three groups: 30 cases of group A were treated with intraoperative intraoperative injection of 1 g carbamate powder before suture, and intravenous injection of 1 g of methoxycycline powder into 100ml of normal saline, 15 min before skin incision, intravenously, intravenously, intravenously, intravenously, intravenously, intravenously, and intravenously. A total of 30 patients in Group B, 30 cases in Group C, 30 cases in Group C and 30 cases in Group C, were compared with the control group in the total amount of blood loss during perioperative period, the amount of dominant blood loss, and the amount of recessive blood loss 72 hours after operation. The changes of coagulation function [prothrombin time (PTT), activated partial thromboplastin time (APTTT) D-Dimer]. Results: compared with the control group, the total blood loss, dominant blood loss and recessive blood loss at 72 hours after operation in intravenous medication group were higher than those in control group. There was no significant difference in coagulation function between local drug group and blank group, compared with the control group, the total blood loss and dominant blood loss in the local medication group were higher than those in the control group. 72 hours after operation, the amount of recessive blood loss was significantly lower than that of the blank group (P 0.05), the coagulation function of the two groups was not significantly different from that of the control group (P 0.05), the total blood loss and the dominant blood loss in the local and intravenous groups were higher than those in the control group. 72 hours after operation, the amount of recessive blood loss was significantly lower than that of intravenous medication group (P 0.05), and there was no significant difference in coagulation function between the two groups. Conclusion: local application of carbamoic acid in posterior lumbar interbody fusion can significantly reduce the total blood loss and dominant blood loss during perioperative period. The amount of recessive blood loss at 72 hours after operation was not significantly affected by intravenous low dose of carbamoic acid on the total blood loss, dominant blood loss and 72 hours of recessive blood loss in perioperative patients.
【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】：R687.3

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