84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]王慶東,李付彬,徐向峰,等.氨甲環(huán)酸術(shù)前靜脈滴注聯(lián)合術(shù)中關(guān)節(jié)內(nèi)注射對 全膝關(guān)節(jié)置換術(shù)圍手術(shù)期失血量的影響[J].中醫(yī)正骨,2016,28(01):24-27.
　WANG Qingdong,LI Fubin,XU Xiangfeng,et al.Effect of preoperative intravenous drip infusion and intraoperative intra-articular injection of tranexamic acid on perioperative blood loss of total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(01):24-27.
點擊復(fù)制

氨甲環(huán)酸術(shù)前靜脈滴注聯(lián)合術(shù)中關(guān)節(jié)內(nèi)注射對 全膝關(guān)節(jié)置換術(shù)圍手術(shù)期失血量的影響()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年01期
頁碼:
24-27
欄目:
臨床研究
出版日期:
2016-01-20

文章信息/Info

Title:
Effect of preoperative intravenous drip infusion and intraoperative intra-articular injection of tranexamic acid on perioperative blood loss of total knee arthroplasty
作者:
王慶東; 李付彬; 徐向峰; 李杰峰; 金艷南; 康樂; 彭高峰
漯河醫(yī)學(xué)高等專科學(xué)校第二附屬醫(yī)院,河南 漯河 462300
Author(s):
WANG Qingdong; LI Fubin; XU Xiangfeng; LI Jiefeng; JIN Yannan; KANG Le; PENG Gaofeng
The Second Affiliated Hospital of Luohe medical high training school,Luohe 462300,Henan,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù);  置換;  膝;  氨甲環(huán)酸;  失血; 手術(shù);  圍手術(shù)期;  輸注; 靜脈內(nèi);  注射; 關(guān)節(jié)內(nèi);  治療; 臨床研究性
Keywords:
arthroplasty; replacement; knee;  tranexamic acid;  blood loss; surgical;  perioperative period;  infusions; intravenous;  injections; intra-articular;  therapies; investigational
摘要:
目的:觀察氨甲環(huán)酸(tranexamic acid,TXA)術(shù)前靜脈滴注聯(lián)合術(shù)中關(guān)節(jié)內(nèi)注射對全膝關(guān)節(jié)置換術(shù)(total knee arthroplasty,TKA)圍手術(shù)期失血量的影響。方法:將64例接受TKA治療的單側(cè)膝骨關(guān)節(jié)炎患者隨機(jī)分為聯(lián)合用藥組和關(guān)節(jié)注射組,每組32例。2組手術(shù)方式及所選假體完全一致。聯(lián)合用藥組在止血帶充氣前10 min靜脈滴注1 g TXA注射液,同時在手術(shù)關(guān)閉筋膜層后通過引流管逆行向關(guān)節(jié)內(nèi)注射TXA溶液(2 g TXA注射液加20 mL生理鹽水),并夾閉引流管2 h; 關(guān)節(jié)注射組僅在手術(shù)關(guān)閉筋膜層后通過引流管逆行向關(guān)節(jié)內(nèi)注射TXA溶液,并夾閉引流管2 h。術(shù)后測量2組患者的引流量、術(shù)后4 d時的總失血量,并觀察下肢深靜脈血栓形成(deep venous thrombosis,DVT)的發(fā)生情況。結(jié)果:2組患者的手術(shù)時間和引流量比較,組間差異均無統(tǒng)計學(xué)意義[(62.9±4.1)min,(63.8±4.0)min,t=-0.526,P=0.601;(121.00±26.00)mL,(132.00±28.00)mL,t=-1.638,P=0.107]; 聯(lián)合用藥組術(shù)后4 d時的總失血量少于關(guān)節(jié)注射組[(500.00±116.00)mL,(589.00±108.00)mL,t=-3.078,P=0.002]。至術(shù)后7 d時聯(lián)合用藥組2例發(fā)生DVT,關(guān)節(jié)注射組1例發(fā)生DVT,均為小腿肌間靜脈血栓,繼續(xù)給予原劑量抗凝藥物,至術(shù)后2周時3例患者的血栓均消失。2組患者的DVT發(fā)生率比較,差異無統(tǒng)計學(xué)意義(χ2=0.000,P=1.000)。結(jié)論:TXA術(shù)前靜脈滴注聯(lián)合術(shù)中關(guān)節(jié)內(nèi)注射可有效減少TKA圍手術(shù)期失血量,而且不增加發(fā)生DVT的風(fēng)險。
Abstract:
Objective:To observe the effect of preoperative intravenous drip infusion and intraoperative intra-articular injection of tranexamic acid(TXA)on perioperative blood loss of total knee arthroplasty(TKA).Methods:Sixty-four patients with unilateral knee osteoarthritis who were treated with TKA were randomly divided into combination group and intra-articular injection group,32 cases in each group.The two groups were completely consistent with each other in the operative procedures and the selected prosthesis.The patients in combination group were treated with intravenous drip infusion of TXA(1 g)at 10 min before tourniquet inflated and antidromic intra-articular injection of TXA(2 g)through the drainage tube after the fascia were sutured.Moreover,the drainage tubes were closed for 2 hours.The patients in intra-articular injection group were only treated with the monotherapy of antidromic intra-articular injections of TXA.The postoperative drainage,total blood loss and incidence rate of lower extremity deep venous thrombosis(DVT)were measured and compared between the 2 groups.Results:There was no statistical difference in the operation time and the postoperative drainage between the 2 groups(62.9+/-4.1 vs 63.8+/-4.0 min,t=-0.526,P=0.601; 121.00+/-26.00 vs 132.00+/-28.00 mL,t=-1.638,P=0.107).The total blood loss of combination group was less than that of intra-articular injection group at 4 days after the surgery(500.00+/-116.00 vs 589.00+/-108.00 mL,t=-3.078,P=0.002).DVT was found in combination group(2 cases)and intra-articular injection group(1 case)within 7 days postoperatively,and the 3 cases were diagnosed as surae intermuscular venous thrombosisThe anticoagulants were used in former dosage and the thrombus of the 3 patients disappeared at 2 weeks after the surgery.There was no statistical difference in the incidence rate of DVT between the 2 groups(χ2=0.000,P=1.000).Conclusion:Combination of preoperative intravenous drip infusion with intraoperative intra-articular injection of TXA can effectively reduce perioperative blood loss of TKA and do not increase the risk of DVT.

參考文獻(xiàn)/References:

[1] Callaghan JJ,O'Rourke MR,Liu SS.Blood management:issues and options[J].J Arthroplasty,2005,20(4 Suppl 2):51-54.
[2] Garvin KL,Konigsberg BS.Infection following total knee arthroplasty:prevention and management[J].J Bone Joint Surg Am,2011,93(12):1167-1175.
[3] Matar WY,Jafari SM,Restrepo C,et al.Preventing infection in total joint arthroplasty[J].J Bone Joint Surg Am,2010,92(Suppl 2):36-46.
[4] Sinha A,Sinha M,Burgert S.Reinfusion of drained blood as an alternative to homologous blood transfusion after total knee replacement[J].Int Orthop,2001,25(4):257-259.
[5] Raleigh E,Hing CB,Hanusiewicz AS,et al.Drain clamping in knee arthroplasty,a randomized controlled trial[J].ANZ J Surg,2007,77(5):333-335.
[6] Raut VV,Stone MH,Wroblewski BM.Reduction of postoperative blood loss after press-fit condylar knee arthroplasty with use of a femoral intramedullary plug[J].J Bone Joint Surg Am,1993,75(9):1356-1357.
[7] 張曉強(qiáng),高菲菲,王戰(zhàn)朝,等.膝傷活血靈口服配合低分子肝素鈣皮下注射對全膝關(guān)節(jié)置換術(shù)后隱性失血的影響[J].中醫(yī)正骨,2014,27(4):23-25.
[8] Mutsuzaki H,Ikeda K.Intra-articular injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in cementless total knee arthroplasty[J].J Orthop Surg Res,2012,7(32):32.
[9] Veien M,Sørensen JV,Madsen F,et al.Tranexamic acid given intraoperatively reduces blood loss after total knee replacement:a randomized, controlled study[J].Acta Anaesthesiol Scand,2002,46(10):1206-1211.
[10] 鞏建寶,孫水,張偉,等.初次全膝關(guān)節(jié)置換術(shù)后引流管夾閉時間選擇與隱性失血量的相關(guān)性研究[J].中國矯形外科雜志,2014,22(7):589-593.
[11] Carson JL,Grossman BJ,Kleinman S,et al.Red blood cell transfusion:a clinical practice guideline from the AABB[J].Ann Intern Med,2012,157(1):49-58.
[12] Nadler SB,Hidalgo JU,Bloch T.Prediction of blood volume in normal human adults[J].Surgery,1962,51(2):224-232.
[13] Astedt B.Clinical pharmacology of tranexamic acid[J].Scand J Gastroenterol Suppl,1987,137:22-25.
[14] 朱云森,江敞,李俊.氨甲環(huán)酸對老年股骨轉(zhuǎn)子間骨折髓內(nèi)固定術(shù)圍手術(shù)期隱性失血的影響[J].中醫(yī)正骨,2015,27(6):16-18.
[15] Dunn CJ,Goa KL.Tranexamic acid:a review of its use in surgery and other indications[J].Drugs,1999,57(6):1005-1032.
[16] Whiting DR,Gillette BP,Duncan C,et al.Preliminary results suggest tranexamic acid is safe and effective in arthroplasty patients with severe comorbidities[J].Clin Orthop Relat Res,2014,472(1):66-72.
[17] Good L,Peterson E,Lisander B.Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement[J].Br J Anaesth,2003,90(5):596-599.
[18] Cid J,Lozano M.Tranexamic acid reduces allogeneic red cell transfusions in patients undergoing total knee arthroplasty:results of a meta-analysis of randomized controlled trials[J].Transfusion,2005,45(8):1302-1307.
[19] Murkin JM,Falter F,Granton J,et al.High-dose tranexamic Acid is associated with nonischemic clinical seizures in cardiac surgical patients[J].Anesth Analg,2010,110(2):350-353. 中醫(yī)正骨2016年1月第28卷第1期 J Trad Chin Orthop Trauma,2016,Vol.28,No.1(總027) (總028)中醫(yī)正骨2016年1月第28卷第1期 J Trad Chin Orthop Trauma,2016,Vol.28,No.1
[20] Panteli M,Papakostidis C,Dahabreh Z,et al.Topical tranexamic acid in total knee replacement:a systematic review and meta-analysis[J].Knee,2013,20(5):300-309.
[21] Ralley FE,Berta D,Binns V,et al.One intraoperative dose of tranexamic Acid for patients having primary hip or knee arthroplasty[J].Clin Orthop Relat Res,2010,468(7):1905-1911.
[22] Maniar RN,Kumar G,Singhi T,et al.Most effective regimen of tranexamic acid in knee arthroplasty:a prospective randomized controlled study in 240 patients[J].Clin Orthop Relat Res,2012,470(9):2605-2612.
[23] Tanaka N,Sakahashi H,Sato E,et al.Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee[J].J Bone Joint Surg Br,2001,83(5):702-705.
[24] Iwai T,Tsuji S,Tomita T,et al.Repeat-dose intravenous tranexamic acid further decreases blood loss in total knee arthroplasty[J].Int Orthop,2013,37(3):441-445.
[25] Ellis MH,Fredman B,Zohar E,et al.The effect of tourniquet application,tranexamic acid,and desmopressin on the procoagulant and fibrinolytic systems during total knee replacement[J].J Clin Anesth,2001,13(7):509-513.
[26] Gillette BP,Desimone LJ,Trousdale RT,et al.Low risk of thromboembolic complications with tranexamic acid after primary total hip and knee arthroplasty[J].Clin Orthop Relat Res,2013,471(1):150-154.
[27] Eubanks JD.Antifibrinolytics in major orthopaedic surgery[J].J Am Acad Orthop Surg,2010,18(3):132-138.
[28] Kim YH,Kim JS.Incidence and natural history of deep-vein thrombosis after total knee arthroplasty.A prospective, randomised study[J].J Bone Joint Surg Br,2002,84(4):566-570.

相似文獻(xiàn)/References:

[1]樊慶陽,任凱晶.定制3D打印切模輔助全膝關(guān)節(jié)置換術(shù)治療 膝骨關(guān)節(jié)炎合并股骨干骨折畸形愈合[J].中醫(yī)正骨,2015,27(11):37.
[2]李翰林,童培建.利福平聯(lián)合用藥配合保留假體清創(chuàng)治療 人工關(guān)節(jié)置換術(shù)后早期感染及低毒性感染[J].中醫(yī)正骨,2015,27(09):56.
[3]劉曉雅,孫永強(qiáng),劉國杰.主動快速康復(fù)鍛煉對全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)活動度的影響[J].中醫(yī)正骨,2015,27(09):73.
[4]張維平,康兩期,陳衛(wèi),等.全髖關(guān)節(jié)置換術(shù)圍手術(shù)期隱性失血的研究進(jìn)展[J].中醫(yī)正骨,2015,27(08):61.
[5]宋兵華,孫俊英,倪增良,等.全膝關(guān)節(jié)置換術(shù)前CT測量股骨后髁角的臨床意義[J].中醫(yī)正骨,2015,27(07):38.
[6]王金良,孫京濤,李玲,等.骨水泥聯(lián)合螺釘修復(fù)全膝關(guān)節(jié)置換術(shù)中 脛骨平臺內(nèi)側(cè)骨缺損[J].中醫(yī)正骨,2015,27(12):55.
[7]徐偉鋒,葉健,吳連國.強(qiáng)骨飲對骨質(zhì)疏松性股骨頸骨折患者全髖關(guān)節(jié)置換術(shù)后 血清骨代謝生化指標(biāo)和骨密度的影響[J].中醫(yī)正骨,2015,27(02):12.
　XU Weifeng,YE Jian,WU Lianguo.Effect of Qianggu Yin(強(qiáng)骨飲,QGY)on serum bone metabolism indexes and bone density after total hip arthroplasty in patients with osteoporotic femoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):12.
[8]張榮,王健.人工全膝關(guān)節(jié)置換術(shù)的圍手術(shù)期心理護(hù)理[J].中醫(yī)正骨,2015,27(05):77.
[9]齊志遠(yuǎn),陳秀民,王在斌,等.桃紅四物加黃芪湯預(yù)防人工髖膝關(guān)節(jié)置換術(shù)后 下肢深靜脈血栓形成[J].中醫(yī)正骨,2015,27(03):71.
[10]陸吳超,季衛(wèi)鋒,馬鎮(zhèn)川.關(guān)節(jié)鏡下清創(chuàng)后持續(xù)灌洗聯(lián)合中藥口服治療 全膝關(guān)節(jié)置換術(shù)后急性期感染[J].中醫(yī)正骨,2015,27(01):51.

備注/Memo

備注/Memo:
通訊作者:李付彬 E-mail:[email protected]
更新日期/Last Update: 2016-02-29