氨甲环酸减少膝关节置换术术后失血效果观察

发布时间：2018-01-13 07:22

本文关键词：氨甲环酸减少膝关节置换术术后失血效果观察　出处：《人民军医》2015年11期 　论文类型：期刊论文

【摘要】：目的:观察氨甲环酸静脉滴注结合局部关节腔注入对减少全膝关节置换术(TKA)失血的效果。方法:选择行TKA60例,随机分为观察组和对照组各30例。观察组在放松止血带前静脉滴注氨甲环酸10mg/kg,在安装假体结束及缝合关节囊后通过引流管注入氨甲环酸溶液50ml(氨甲环酸1g),并临时夹闭引流管1h;对照组在放松止血带前静脉滴注氨甲环酸10mg/kg,在安装假体结束及缝合关节囊后通过引流管注入生理盐水50ml,并临时夹闭引流管1h。比较两组术中出血量、隐性失血量、总失血量、术后总引流量、术后24h血红蛋白水平、输血情况及不良反应发生情况。结果:观察组术后总引流量、隐性失血量、总失血量均显著低于对照组(P0.05),术后24h血红蛋白水平非常显著高于对照组(P0.01);两组术中失血量比较,差异不显著(P0.05)。观察组无输血病例,对照组输血4例;两组均无术后感染、肺栓塞及下肢深静脉血栓形成等并发症发生。结论:静脉滴注结合关节腔注入氨甲环酸溶液可有效减少TKA术后失血量。
[Abstract]:Objective: to observe the effect of intravenously instilled methacylic acid combined with local articular cavity injection on reducing blood loss in total knee arthroplasty (TKA). Methods: TKA60 was performed in patients with total knee arthroplasty (TKA). They were randomly divided into observation group (n = 30) and control group (n = 30). After the prosthesis was installed and the joint capsule was sutured, the drainage tube was injected with 50 ml of carbamoic acid solution (1 g of methocylic acid) and the drainage tube was temporarily clipped for 1 hour. In the control group, 10 mg / kg carbonic acid was injected intravenously before the release of the tourniquet, and 50 ml saline was injected through the drainage tube after the prosthesis was installed and the joint capsule was sutured. The volume of blood loss, recessive blood loss, total blood loss, postoperative drainage volume and hemoglobin level 24 hours after operation were compared between the two groups. Results: the total drainage volume, recessive blood loss and total blood loss in the observation group were significantly lower than those in the control group (P 0.05). The hemoglobin level at 24 hours after operation was significantly higher than that in the control group (P 0.01). There was no significant difference in blood loss between the two groups (P 0.05). There were no cases of blood transfusion in the observation group and 4 cases in the control group. There was no postoperative infection, pulmonary embolism and deep venous thrombosis of lower extremity in both groups. Conclusion: intravenous drip combined with articular instillation of carbamoic acid solution can effectively reduce the amount of blood loss after TKA.
【作者单位】：新乡医学院第一临床学院骨外一病区;
【分类号】：R687.4
【正文快照】： 全膝关节置换术(TKA)通常失血量较大,常规应用止血带可有效减少TKA术中出血;但止血带的使用可能激活局部纤溶系统,进而增加TKA术后出血量[1]。氨甲环酸能可逆性地阻断纤溶酶和纤溶酶原赖氨酸结合点,发挥抗纤维蛋白溶解作用。Meta分析结果[2]显示,氨甲环酸可显著减少术后失血量

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