TKA后关节腔注入氨甲环酸与肾上腺素对患者出血及凝血功能的影响

发布时间：2018-06-08 04:35

本文选题：关节置换术 + 膝关节　；参考：《山东医药》2017年32期

【摘要】：目的探讨关节腔注入氨甲环酸与肾上腺素混合液对全膝关节置换术(TKA)后患者出血及凝血功能的影响。方法选择初次行单侧TKA患者64例,随机分为观察组和对照组,每组32例。两组常规进行TKA,术后留置引流管。观察组通过引流管向关节腔内注入含3.0 g氨甲环酸、0.25 mg肾上腺素的生理盐水50 m L,对照组通过引流管向关节腔内注入含3.0 g氨甲环酸的生理盐水50 m L,两组均夹闭引流管2 h。观察两组出血量(包括术中出血量、隐形出血量及总出血量)、术后引流量;两组术前及术后24 h采用全自动生化分析仪检测血红蛋白(Hb)、红细胞压积(PCV)、凝血酶原时间(PT)、活化的部分凝血活酶时间(APTT)。结果两组术中出血量比较无统计学差异(P0.05);观察组隐性出血量、总出血量及术后引流量均低于对照组(P0.05或0.01)。与术前比较,两组术后24 h Hb、PCV均降低,观察组术后24 h PT升高(P均0.05);对照组术后24 h PT、APTT均较术前无明显变化(P均0.05)。术后24 h,观察组Hb、PCV均高于对照组(P均0.01),两组PT、APTT比较差异均无统计学意义(P均0.05)。结论关节腔内局部注入氨甲环酸与肾上腺素混合液可减少TKA患者术后出血,且对其凝血功能影响较小。
[Abstract]:Objective to investigate the effects of intraarticular injection of methacylic acid and epinephrine on bleeding and coagulation after total knee arthroplasty (TKA). Methods 64 patients with unilateral TKA were randomly divided into observation group and control group with 32 cases in each group. Two groups of routine TKA, postoperative indwelling drainage tube. In the observation group, 50 mL saline containing 0.25 mg epinephrine was injected into the articular cavity through the drainage tube, while the control group was injected into the articular cavity with 3.0 g normal saline containing 3.0 g methoxycycline. The drainage tubes were clamped for 2 h in both groups. The amount of blood loss (including intraoperative volume, invisible volume and total volume of bleeding) and postoperative drainage volume were observed in the two groups. Before operation and 24 hours after operation, the hemoglobin, hematocrit, prothrombin time and activated partial thromboplastin time (APTTT) were detected by automatic biochemical analyzer. Results there was no significant difference in the amount of intraoperative bleeding between the two groups (P 0.05), but the hidden bleeding, total bleeding and postoperative drainage in the observation group were lower than those in the control group (P0.05 or 0.01). Compared with those before operation, the PCV of the two groups decreased at 24 hours after operation, the PT of the observation group increased at 24 hours after operation (P < 0.05), and the APTT of the control group at 24 hours after operation was not significantly different from that of the control group (P < 0.05). 24 hours after operation, the PCV in the observation group was higher than that in the control group (P < 0.01), and there was no significant difference in APTT between the two groups (P < 0.05). Conclusion Intraarticular intraarticular injection of the mixture of carbamoic acid and epinephrine can reduce postoperative bleeding in TKA patients and has little effect on the coagulation function of TKA patients.
【作者单位】：延边大学附属医院;
【分类号】：R687.4

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