氨甲环酸序贯利伐沙班在全髋关节置换围手术期有效性与安全性研究
发布时间：2018-07-24 19:56
【摘要】：目的探索全髋关节置换术(THA)应用氨甲环酸后序贯应用利伐沙班的有效性与安全性。方法根据随机对照原则设计,选取2012年9月～2015年6月拟初次单侧THA患者150例。随机分为A、B、C、D、E共5组,每组30例。A组患者不使用氨甲环酸,B组患者在切皮前10mins予10mg/kg氨甲环酸静滴,C组患者在切皮前10mins予15mg/kg氨甲环酸静滴,D组患者在切皮前10mins及3h后分别予15mg/kg氨甲环酸静滴,E组患者在切皮前10mins予15mg/kg氨甲环酸静滴,关闭切口前再予1g氨甲环酸关节腔局部浸泡使用。术后6h引流量30ml/h时给予利伐沙班10mmg口服,以后按常规剂量使用至术后35d。观察A、B、C、D、E这5组患者术中出血量、术后引流量、总失血量、输血率、术后第1天凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、拔除引流管后血红蛋白(Hb)下降值的差异及术后深静脉血栓(DVT)及肺栓塞(PE)的发生率。结果五组患者术中出血量、术后引流量、总失血量、输血率、拔管后Hb下降值差异具有统计学意义(P0.05)。所有患者围手术期及术后1个月、3个月门诊随访均未发生DVT及PE。结论THA围手术期应用氨甲环酸后序贯应用利伐沙班是安全、有效的,切皮前10mins及3h后分别予15mg/kg氨甲环酸静滴对减少THA围手术期失血量的疗效最为显著。
[Abstract]:Objective to explore the effectiveness and safety of the sequential application of Lev Shaaban after total hip replacement (THA). Methods according to the random control principle, 150 cases of first unilateral THA from September 2012 to June 2015 were selected and randomly divided into 5 groups of A, B, C, D, E, and 30 patients in each group did not use methicyclic acid, and the patients in group B were in the skin. The anterior 10mins was given to 10mg/kg methicate, and the patients in group C were intravenous drip of 15mg/kg methicate before cutting the skin, and the patients in group D were intravenous drip of 15mg/kg methicate after 10mins and 3H before the skin incision. The E group was given 15mg/kg ammonia methicate before cutting the skin and closed to the incision before closing the incision. The flow rate of 30ml/h was given to LEV Shaaban 10mmg orally, and then the 5 groups of patients with A, B, C, D, E were used to observe the amount of bleeding during the operation, the postoperative flow rate, the total blood loss, the blood transfusion rate, the first day thrombin time (PT) after operation, and the difference in the reduction of hemoglobin (Hb) after removal of the drainage tube after the operation. Results the incidence of posterior deep venous thrombosis (DVT) and pulmonary embolism (PE). Results there were significant differences in the amount of intraoperative bleeding, postoperative flow rate, total blood loss, blood transfusion rate, and Hb decline after extubation (P0.05). All patients in the perioperative period and 1 months after the operation, and 3 months of 3 month follow-up, did not have DVT and PE. in the perioperative period of the application of methylene rings in the perioperative period of THA operation. The sequential application of Lev Shaaban after acid after acid is safe and effective. The effect of 15mg/kg methicate acid intravenous drip before 10mins and 3H before skin resection is the most effective for reducing the blood loss in the perioperative period of THA.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4
[Abstract]:Objective to explore the effectiveness and safety of the sequential application of Lev Shaaban after total hip replacement (THA). Methods according to the random control principle, 150 cases of first unilateral THA from September 2012 to June 2015 were selected and randomly divided into 5 groups of A, B, C, D, E, and 30 patients in each group did not use methicyclic acid, and the patients in group B were in the skin. The anterior 10mins was given to 10mg/kg methicate, and the patients in group C were intravenous drip of 15mg/kg methicate before cutting the skin, and the patients in group D were intravenous drip of 15mg/kg methicate after 10mins and 3H before the skin incision. The E group was given 15mg/kg ammonia methicate before cutting the skin and closed to the incision before closing the incision. The flow rate of 30ml/h was given to LEV Shaaban 10mmg orally, and then the 5 groups of patients with A, B, C, D, E were used to observe the amount of bleeding during the operation, the postoperative flow rate, the total blood loss, the blood transfusion rate, the first day thrombin time (PT) after operation, and the difference in the reduction of hemoglobin (Hb) after removal of the drainage tube after the operation. Results the incidence of posterior deep venous thrombosis (DVT) and pulmonary embolism (PE). Results there were significant differences in the amount of intraoperative bleeding, postoperative flow rate, total blood loss, blood transfusion rate, and Hb decline after extubation (P0.05). All patients in the perioperative period and 1 months after the operation, and 3 months of 3 month follow-up, did not have DVT and PE. in the perioperative period of the application of methylene rings in the perioperative period of THA operation. The sequential application of Lev Shaaban after acid after acid is safe and effective. The effect of 15mg/kg methicate acid intravenous drip before 10mins and 3H before skin resection is the most effective for reducing the blood loss in the perioperative period of THA.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4
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