氨甲环酸联合自体血回输对膝关节表面置换术失血量影响的疗效观察

发布时间：2018-09-06 08:56

【摘要】：目的观察术中静脉使用氨甲环酸对于初次、单侧膝关节表面置换术并且术后采用自体血回输的该类病例的止血效果及安全性评价。方法采用随机对照的前瞻性研究方法,自2015年1月至2016年2月,共有124例纳入研究,将其分为试验组(氨甲环酸静脉滴注)和对照组(生理盐水滴注),分别记录及比较两组的术后引流量、自体血回输量、术后血红蛋白及红细胞压积、术后凝血指标、总失血量及隐性失血量、异体输血例数以及输血量。结果试验组术后6h引流量及自体血回输量较对照组少,术后1、3d血红蛋白及红细胞压积降低值小,术后1dD二聚体较低,术后总失血量及隐性失血量较小,差异均有统计学意义(P0.05)。试验组有1例需要输异体血,明显低于对照组(6例)。两组均无深静脉血栓及其他重大并发症出现。结论在初次、单侧膝关节置换术中使用止血带及不特殊止血,术后采用自体血回输的患者中,关闭切口时静脉使用氨甲环酸(15mg/kg)能够有效减少总失血量,特别是术后早期引流量,能够降低异体血输血比例并且不增加深静脉血栓的风险。
[Abstract]:Objective to evaluate the hemostatic effect and safety of intraoperative intravenous use of carbamoic acid in patients undergoing primary, unilateral knee joint surface replacement and postoperative autologous blood transfusion. Methods from January 2015 to February 2016, 124 patients were enrolled in a prospective randomized controlled study. The patients were divided into two groups: the experimental group and the control group. The postoperative drainage volume, autologous blood volume, hemoglobin and hematocrit were recorded and compared between the two groups. Total and recessive blood loss, cases of allogeneic blood transfusion and blood transfusion volume. Results the drainage volume and autologous blood volume in the test group were less than those in the control group, the hemoglobin and hematocrit decreased at 1 ~ 3 days after operation, the 1dD dimer was lower, the total blood loss and the recessive blood loss were smaller in the experimental group than in the control group (P0.05). One case in the test group needed allogeneic blood transfusion, which was significantly lower than that in the control group (6 cases). There were no deep venous thrombosis and other major complications in both groups. Conclusion in the primary, unilateral knee arthroplasty patients who used tourniquet or no special hemostasis and who received autologous blood transfusion after operation, intravenous use of 15mg/kg at the time of closure of the incision could effectively reduce the total bleeding loss, especially the early postoperative drainage. It can reduce the proportion of allogeneic blood transfusion without increasing the risk of deep venous thrombosis.
【作者单位】：南京中医药大学无锡附属医院;
【分类号】：R687.4

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