全髋关节置换术围术期氨甲环酸全身与局部联合应用临床观察
发布时间：2018-07-18 14:21
【摘要】：目的探讨全髋关节置换术(THA)围术期氨甲环酸全身与局部联合应用的临床效果。方法选取初次拟行单侧THA的股骨头缺血性坏死患者60例,随机分为局部组和联合组,各30例。局部组分别于髋臼、股骨髓腔局部注射氨甲环酸0.5 g浸泡5 min,并经引流管逆行灌注氨甲环酸0.5 g;联合组在手术切皮前15 min静滴氨甲环酸15 mg/kg,并采用与局部组同样的方法进行局部处理。记录两组术后6 h及12、24 d引流量,术前及术后1、3 d血红蛋白(Hb)、红细胞压积(HCT),总出血量、输血情况及术后深静脉血栓形成(DVT)、肺栓塞(PE)发生情况。结果联合组术后6 h及12、24 d引流量均低于局部组同时间点(P均0.05)。与术前比较,两组术后1、3 d Hb、HCT均降低,但局部组降低更明显(P均0.05)。联合组总出血量及输血率均低于局部组(P均0.05)。两组术后均未发生DVT及PE。结论行THA患者术前氨甲环酸静滴联合术中髋臼及股骨髓腔局部注射、术后引流管逆行灌注可减少手术期出血,安全性高。
[Abstract]:Objective to investigate the clinical effect of total hip arthroplasty (tha) combined with local and systemic application of carbamoic acid during perioperative period. Methods 60 patients with avascular necrosis of femoral head were randomly divided into local group and combined group. The local group was located in acetabular, The femoral medullary cavity was soaked with methacylic acid 0.5 g for 5 minutes and retrograde instilled in the drainage tube for 0.5 g. The combined group was treated with the same method as the local group 15 mg 路kg ~ (-1) by intravenous drip 15 min before skin incision. Hemoglobin (HB), hematocrit (HCT), total blood loss, blood transfusion, deep venous thrombosis (DVT) and pulmonary embolism (PE) were recorded at 6 h and 12 h after operation in both groups, and hemoglobin (HB), hematocrit (HCT), blood transfusion, deep venous thrombosis (DVT) and pulmonary embolism (PE) were recorded before and after operation. Results the drainage volume in the combined group was lower than that in the local group at 6 h and 12 d after operation (P 0.05). Compared with pre-operation, HCT in both groups was decreased 1 and 3 days after operation, but the decrease in local group was more obvious (P 0.05). The total blood loss and blood transfusion rate in the combined group were lower than those in the local group (P 0.05). DVT and Pe were not found in both groups. Conclusion Local injection of acetabular and femoral medullary cavity and retrograde perfusion of drainage tube in patients with tha before operation can reduce bleeding during operation and is safe.
【作者单位】： 河南省洛阳正骨医院河南省骨科医院;
【分类号】：R687.4
[Abstract]:Objective to investigate the clinical effect of total hip arthroplasty (tha) combined with local and systemic application of carbamoic acid during perioperative period. Methods 60 patients with avascular necrosis of femoral head were randomly divided into local group and combined group. The local group was located in acetabular, The femoral medullary cavity was soaked with methacylic acid 0.5 g for 5 minutes and retrograde instilled in the drainage tube for 0.5 g. The combined group was treated with the same method as the local group 15 mg 路kg ~ (-1) by intravenous drip 15 min before skin incision. Hemoglobin (HB), hematocrit (HCT), total blood loss, blood transfusion, deep venous thrombosis (DVT) and pulmonary embolism (PE) were recorded at 6 h and 12 h after operation in both groups, and hemoglobin (HB), hematocrit (HCT), blood transfusion, deep venous thrombosis (DVT) and pulmonary embolism (PE) were recorded before and after operation. Results the drainage volume in the combined group was lower than that in the local group at 6 h and 12 d after operation (P 0.05). Compared with pre-operation, HCT in both groups was decreased 1 and 3 days after operation, but the decrease in local group was more obvious (P 0.05). The total blood loss and blood transfusion rate in the combined group were lower than those in the local group (P 0.05). DVT and Pe were not found in both groups. Conclusion Local injection of acetabular and femoral medullary cavity and retrograde perfusion of drainage tube in patients with tha before operation can reduce bleeding during operation and is safe.
【作者单位】： 河南省洛阳正骨医院河南省骨科医院;
【分类号】：R687.4
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