初次单侧全膝关节置换术中局部应用氨甲环酸止血效果观察

发布时间：2018-08-28 07:00

【摘要】：目的观察初次单侧全膝关节置换术(TKA)中局部应用氨甲环酸的临床效果。方法收集90例膝关节骨关节炎患者,随机分为观察组和对照组各45例,均行初次单侧TKA治疗。术中观察组应用含氨甲环酸1 g/1 000 m L的生理盐水冲洗关节腔,缝合关节囊后经引流管注入含1 g氨甲环酸的生理盐水50 m L,术后夹闭3 h;对照组未使用氨甲环酸。术后测算两组围手术期的实际失血量、显性失血量、隐性失血量、输血量、输血率,检测术后第1、3、5天的血红蛋白(Hb),观察下肢瘀斑发生情况,术后第5天常规行下肢动静脉超声筛查有无深静脉血栓形成(DVT)。结果与对照组比较,观察组实际失血量、显性失血量、隐性失血量、输血量、输血率及术后同时点Hb均低于对照组(P均0.05)。两组DVT发生率比较差异无统计学意义,观察组术后下肢瘀斑发生率低于对照组(P0.05)。结论初次单侧TKA术中局部应用氨甲环酸,能减少患者显性及隐性失血量,降低输血量及输血率,且不增加DVT的发生。
[Abstract]:Objective to observe the clinical effect of local application of carbamoic acid in primary unilateral total knee arthroplasty (TKA). Methods 90 cases of knee osteoarthritis were randomly divided into observation group (n = 45) and control group (n = 45). In the observation group, intraoperative saline containing 1 g / 1 000 mL of methocycline was used to wash the articular cavity, and 50 mL saline containing 1 g methocylic acid was injected into the joint capsule through the drainage tube after closure for 3 hours, while the control group was not treated with the methacylic acid. The actual blood loss, apparent blood loss, recessive blood loss, blood transfusion rate and hemoglobin (Hb), of the first 3 days after operation were measured to observe the occurrence of ecchymosis in the lower extremities of the two groups. On the 5th day after operation, the lower extremity arteriovenous ultrasound was routinely performed for the screening of deep venous thrombosis (DVT). Results compared with the control group, the actual amount of blood loss, the amount of dominant blood loss, the amount of recessive blood loss, the blood transfusion rate and the Hb at the same time after operation in the observation group were lower than those in the control group (all P 0.05). There was no significant difference in the incidence of DVT between the two groups. The incidence of ecchymosis in the observation group was lower than that in the control group (P0.05). Conclusion Local application of carbamoic acid in primary unilateral TKA can reduce the amount of dominant and recessive blood loss, decrease the amount of blood transfusion and blood transfusion rate, and do not increase the incidence of DVT.
【作者单位】：胜利油田中心医院;
【分类号】：R687.4

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