發(fā)布時(shí)間：2018-01-16 03:06

  本文關(guān)鍵詞：局部應(yīng)用氨甲環(huán)酸對PFNA圍手術(shù)期隱形失血療效的研究　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 股骨轉(zhuǎn)子間骨折 氨甲環(huán)酸 股骨近端防旋髓內(nèi)釘 隱性失血

【摘要】：目的:探討局部應(yīng)用氨甲環(huán)酸對股骨PFNA手術(shù)隱形失血療效及安全性的研究。方法:回顧性分析了我科于2014年02月01日至2016年11月30日期間診治的132例采用PFNA治療的老年股骨轉(zhuǎn)子間骨折患者的臨床資料。根據(jù)局部應(yīng)用氨甲環(huán)酸的情況分為氨甲環(huán)酸組和對照組。記錄患者術(shù)前(入院當(dāng)天)與術(shù)后第5日的血紅蛋白(Hb)和紅細(xì)胞壓積(Hct);記錄圍手術(shù)期的顯性失血量,采用Cross線性方程計(jì)算總出血量和隱性出血量。于手術(shù)前及術(shù)后第5天分別行雙下肢血管彩超檢查,對比以了解有無血栓形成及相關(guān)并發(fā)癥情況,評價(jià)氨甲環(huán)酸應(yīng)用的安全性。結(jié)果:圍手術(shù)期總失血量:氨甲環(huán)酸組573.61±92.8ml,對照組806.29±98.43ml;隱性失血量:氨甲環(huán)酸組469.76±89.27ml,占總失血量的81.9%,對照組680.69±90.81ml,占總失血量的84.4%;術(shù)后患者輸血情況:氨甲環(huán)酸組12例,占17.65%,對照組21例,占32.81%。兩組術(shù)前血紅蛋白(Hb)比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),Hct變化量及輸血例數(shù)氨甲環(huán)酸組均明顯低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);圍手術(shù)期總的理論失血量、隱性失血量TXA組均明顯低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組顯性失血量比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);而所有132例患者雙下肢均無血栓形成,無血栓相關(guān)疾病病例出現(xiàn)。結(jié)論:對于老年股骨轉(zhuǎn)子間骨折患者,局部應(yīng)用氨甲環(huán)酸可明顯減少圍手術(shù)期總失血量和隱性失血量,并不增加血栓形成及其相關(guān)疾病的發(fā)生風(fēng)險(xiǎn)。
[Abstract]:Objective: to investigate the efficacy and safety of local application of carbamicylic acid in the treatment of stealthy blood loss in PFNA operation. The clinical data of 132 elderly patients with intertrochanteric fracture of femur treated with PFNA from February 1st 2014 to November 30th 2016 were analyzed retrospectively. The patients were divided into two groups: the control group and the control group. The hemoglobin (HB) and hematocrit (HCT) were observed on the first day of admission and on 5th after operation. The dominant blood loss was recorded during perioperative period and the total and recessive blood loss was calculated by Cross linear equation. The blood vessels of both lower limbs were examined by color Doppler ultrasonography before operation and 5 days after operation. Results: total blood loss in perioperative period was 573.61 鹵92.8ml. The control group was 806.29 鹵98.43 ml; Recessive blood loss was 469.76 鹵89.27mlin group, accounting for 81.9 ml of total blood loss, and 680.69 鹵90.81 ml in control group, accounting for 84.4ml of total blood loss. The blood transfusion status of the patients after operation: 12 cases (17.65%) in the carbamicylic acid group and 21 cases in the control group. There was no significant difference between the two groups in the changes of HCT and the number of transfusions of HCT in the two groups, which were significantly lower than those in the control group. The difference was statistically significant (P 0.05). The total theoretical blood loss and recessive blood loss in the TXA group were significantly lower than those in the control group in perioperative period (P 0.05). There was no significant difference in the amount of dominant blood loss between the two groups (P 0.05). All 132 patients had no thrombosis in both lower extremities and no thrombotic related diseases. Conclusion: for the elderly patients with intertrochanteric fracture of femur. Local application of carbonic acid can significantly reduce the total and recessive blood loss in perioperative period, and does not increase the risk of thrombosis and related diseases.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.4

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