氨甲环酸对类风湿关节炎患者全髋关节置换围术期失血的影响

发布时间：2018-06-25 02:11

本文选题：氨甲环酸 + 类风湿关节炎　；参考：《东南大学学报(医学版)》2017年02期

【摘要】：目的:研究氨甲环酸对类风湿关节炎患者全髋关节置换围术期失血的影响。方法:回顾性分析我院2013年4月至2015年7月期间157例因类风湿关节炎(steinbrocker 3、4级)行初次全髋关节置换术患者的临床资料,其中对照组40例未使用氨甲环酸,单次给药组56例在术前20 min静脉滴注氨甲环酸15 mg·kg~(-1),重复给药组61例在单次给药组基础上于术后3 h再次静脉滴注氨甲环酸10 mg·kg~(-1)。比较3组术后总失血量、输血率、深静脉血栓、肺栓塞发生率、凝血指标、术后引流量、术后血红蛋白下降值及并发症情况。结果:与对照组比较,重复给药组和单次给药组总失血量、术后引流量及术后第3天血红蛋白减少值均显著变小,差异具有统计学意义(均P0.05);与单次给药组比较,重复给药组术后总失血量、引流量及术后第3天血红蛋白减少值均进一步减小,差异具有统计学意义(均P0.05)。重复给药组术后输血率明显低于对照组(P0.05)。术后3组患者均未发生深静脉血栓及肺栓塞,且术后凝血指标组间比较均无显著差异(均P0.05)。单次给药组7例、重复给药组5例、对照组6例出现切口并发症,组间比较差异无统计学意义(P0.05)。结论:氨甲环酸静脉滴注可有效降低类风湿关节炎患者全髋关节置换围术期总失血量与输血率,且不增加血栓及并发症的发生。另外,术前及术后3 h重复给药作用优于术前单次使用氨甲环酸。
[Abstract]:Objective: to study the effect of methionine on perioperative blood loss in patients with rheumatoid arthritis (RA) after total hip arthroplasty (THR). Methods: the clinical data of 157 patients with rheumatoid arthritis (steinbrocker 3 grade 4) undergoing primary total hip arthroplasty in our hospital from April 2013 to July 2015 were retrospectively analyzed. 56 patients in the single administration group were intravenously injected with 15 mg kg ~ (-1) of methacylic acid 20 min before operation, and 61 cases in the repeated administration group were given 10 mg kg ~ (-1) of methacylic acid intravenously on the basis of a single dose of the drug at 3 h after operation. The total blood loss, blood transfusion rate, deep vein thrombosis, pulmonary embolism, coagulation index, postoperative drainage volume, hemoglobin decrease and complications were compared among the three groups. Results: compared with the control group, the total blood loss, postoperative drainage volume and hemoglobin reduction on the third day were significantly smaller in the repeated administration group and the single dose group (P0.05), and compared with the single dose group, the difference was significant (P0.05). In the repeated administration group, the total blood loss, drainage volume and hemoglobin reduction on the 3rd day after operation were further reduced, and the difference was statistically significant (P0.05). The blood transfusion rate in the repeated administration group was significantly lower than that in the control group (P0.05). No deep venous thrombosis or pulmonary embolism occurred in the three groups after operation, and there was no significant difference in coagulation indexes between the three groups (P0.05). There were 7 cases in the single administration group, 5 cases in the repeated administration group and 6 cases in the control group. There was no significant difference between the two groups (P0.05). Conclusion: the total blood loss and blood transfusion rate of total hip replacement in patients with rheumatoid arthritis can be effectively reduced by intravenous infusion of ammonia methocycline, and the incidence of thrombosis and complications is not increased. In addition, the effect of repeated administration before operation and 3 hours after operation was better than that of single use of carbamicylic acid before operation.
【作者单位】：常州市中医医院骨科;
【基金】：江苏省自然科学基金资助项目(BK20131485) 常州市科技计划项目(CJ20141205)
【分类号】：R593.22;R687.4

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