静脉及关节腔内注射氨甲环酸减少全膝关节置换术后出血的对比研究

发布时间：2018-04-08 15:51

本文选题：全膝关节置换术　切入点：氨甲环酸　出处：《中国现代医学杂志》2017年22期

【摘要】：目的比较全膝关节置换术中静脉给予氨甲环酸和关节腔内注射氨甲环酸减少出血及降低输血率的有效性。方法 80例因膝关节骨关节炎行全膝关节置换患者随机分为两组:静脉注射氨甲环酸组(1组)和关节腔注射氨甲环酸组(2组)。1组分别在术前、术中、术后静脉注射氨甲环酸3次。2组是在止血带放松前,将3 g氨甲环酸用生理盐水稀释成100 ml溶液,注入关节腔内。术后观察24和48 h的引流量及48 h内的总引流量,术后48 h血红蛋白量,同时监测输血及血栓情况。结果所有膝关节置换手术均顺利完成,无感染、坏死、脂肪液化发生。1组48 h的平均引流量是(409.5±185.8)ml,平均血红蛋白的下降值是(2.42±0.86)mg/dl,2组48 h的平均引流量是(386.5±89.1)ml,平均血红蛋白的下降值是(2.21±0.64)mg/dl。两组间的引流量和血红蛋白下降值比较,差异均无统计学意义(P0.05)。其中1组有3例患者,2组有4例患者需要输血。术后14 d行双下肢彩色多普勒超声检查,均未发现有静脉血栓形成。结论对于减少全膝关节置换术术中出血,关节腔内注射氨甲环酸的作用等同于通过静脉给予3次氨甲环酸所起到的作用。
[Abstract]:Objective to compare the efficacy of intravenous and intraarticular injection of carbamate in total knee arthroplasty to reduce bleeding and blood transfusion rate.Methods 80 patients with knee osteoarthritis underwent total knee arthroplasty were randomly divided into two groups: group 1 with intravenous methocycline (group 1) and group 1 with intraarticular injection (group 1).Before the tourniquet was relaxed, the 3 g carbamate was diluted into 100ml solution with normal saline and injected into the articular cavity.There was no significant difference between the two groups in the drainage flow and the decrease of hemoglobin (P 0.05).There were 3 patients in group 1 and 4 patients in group 2 needed blood transfusion.On the 14th day after operation, no venous thrombosis was found in both lower extremities by color Doppler ultrasonography.Conclusion the effect of intraarticular injection of carbamoic acid on reducing bleeding in total knee arthroplasty is the same as that of intravenous injection of trimethoic acid.
【作者单位】：山东省寿光市人民医院关节创伤外科;
【分类号】：R687.4

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