| 桂斌捷,张金陵,荣根祥,唐 智,钱 军.氨甲环酸联合罗哌卡因对全髋关节置换术后患者凝血功能、失血量和血清CRP、PCT的影响[J].,2021,(23):4559-4563 |
| 氨甲环酸联合罗哌卡因对全髋关节置换术后患者凝血功能、失血量和血清CRP、PCT的影响 |
| Effects of Tranexamic Acid Combined With Ropivacaine on Coagulation Function, Blood Loss, Serum CRP and PCT after Patients with Total Hip Arthroplasty |
| 投稿时间：2021-04-17 修订日期：2021-05-12 |
| DOI：10.13241/j.cnki.pmb.2021.23.034 |
| 中文关键词: 氨甲环酸 罗哌卡因 全髋关节置换术 凝血功能 失血量 C反应蛋白 降钙素原 |
| 英文关键词: Tranexamic acid Ropivacaine Total hip arthroplasty Coagulation function Blood loss C-reactive protein Procalcitonin |
| 基金项目:安徽省高校自然科学研究重大项目（KJ2020ZD23） |
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| 中文摘要: |
| 摘要 目的：观察氨甲环酸联合罗哌卡因对全髋关节置换术（THA）后患者凝血功能、失血量和血清C反应蛋白（CRP）、降钙素原（PCT）的影响。方法：纳入我院2019年1月到2021年6月期间接收的髋关节骨关节炎或股骨头坏死行THA治疗的患者共100例作为研究对象，采用信封抽签的形式分组，分为对照组和研究组，各50例。对照组在缝合手术切口时，采用注射器抽取等量的生理盐水注射于关节腔处。研究组在缝合手术切口时，接受氨甲环酸联合罗哌卡因处理。对比两组凝血功能、失血量、血常规、疼痛情况和血清CRP、PCT，记录两组术后深静脉血栓发生率。结果：研究组的隐性失血量、显性失血量、输血量均少于对照组（P<0.05）。两组术后3 d血红蛋白、红细胞比容较术前下降，但研究组术后3 d血红蛋白、红细胞比容高于对照组（P<0.05）。两组术后3 d凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体（D-D）、纤维蛋白原（FIB）较术前升高，但研究组术后3 d的PT、APTT、D-D、FIB低于对照组（P<0.05）。两组术后3 d疼痛视觉模拟评分（VAS）评分较术后12 h下降，CRP、PCT较术前升高，研究组术后3 d VAS评分、CRP、PCT均低于对照组（P<0.05）。两组术后深静脉血栓发生率对比差异无统计学意义（P>0.05）。结论：氨甲环酸联合罗哌卡因可有效减少THA术后患者的失血量，减轻术后疼痛，控制全身炎性反应，同时减轻手术对机体凝血功能的影响。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of tranexamic acid combined with ropivacaine on coagulation function, blood loss, serum C-reactive protein (CRP) and procalcitonin (PCT) after patients with total hip arthroplasty (THA). Methods: A total of 100 patients with hip osteoarthritis or femoral head necrosis treated with THA who were received in our hospital from January 2019 to June 2021 were included as the research objects. They were divided into control group and study group by envelope lottery, with 50 cases in each group. In the control group, the same amount of normal saline was injected into the joint cavity with a syringe when the incision was closed. The study group was treated with tranexamic acid combined with ropivacaine when the surgical incision was sutured. The coagulation function, blood loss, blood routine, pain, serum CRP and PCT were compared between the two groups, and the incidence of postoperative deep vein thrombosis was recorded. Results: The recessive blood loss, dominant blood loss and blood transfusion in the study group were less than those in the control group (P<0.05). The hemoglobin and hematocrit in the two groups at 3 d after operation decreased than those before operation, but the hemoglobin and hematocrit in the study group at 3 d after operation were higher than those in the control group (P<0.05). Prothrombin time (PT), activated partial thromboplastin time (APTT), D-Dimer (D-D) and fibrinogen (FIB) in the two groups at 3 d after operation were higher than those before operation, but PT, APTT, D-D and FIB in the study group were lower than those in the control group (P<0.05). The visual analogue scale (VAS) of pain in the two groups 3 d after operation was lower than that at 12 h after operation, and the CRP and PCT were higher than those before operation. The VAS score, CRP and PCT in the study group at 3 d after operation were lower than those in the control group (P<0.05). There was no significant difference in the incidence of postoperative deep venous thrombosis between the two groups (P>0.05). Conclusion: Tranexamic acid combined with ropivacaine can effectively reduce blood loss in patients with THA, reduce postoperative pain, control systemic inflammatory reaction, and reduce the impact of operation on blood coagulation function. |
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