全髋关节置换患者应用去氨加压素对围术期输血及失血的影响(1)
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[摘要]目的：探讨去氨加压素对全髋关节置换术(THA)患者围术期出血量的影响。方法：回顾性分析我院2008年5月~2010年5月收治入院的62例拟行单侧THA的患者临床资料，采用随机数字表法分为治疗组和对照组，每组31例。治疗组应用去氨加压素按照0.3 μg/kg溶于100 ml生理盐水配制，静脉滴注，术前30 min应用1次，术后1次/d，连续用2 d；对照组仅给予等剂量生理盐水静脉滴注。比较两组患者失血量、输血量、术后引流量、术前及术后血红蛋白(Hb)、红细胞比容(Hct)、血小板(Plt)、纤维蛋白原(FIB)、凝血酶原时间(PT)及活化部分凝血活酶时间(APTT)等指标，并以彩色多普勒超声观察患者术后下肢深静脉血栓形成的发生情况。结果：治疗组与对照组手术时间差异无统计学意义(P>0.05)；治疗组出血量、输血量、术后引流量明显低于对照组，两组比较差异有统计学意义(P<0.05)，两组患者术后Hb、Hct、Plt及APTT比较差异均有统计学意义(P<0.05)，而Fib、PT比较差异无统计学意义(P>0.05)。术后14 d两组均未发现下肢深静脉血栓形成。45例患者获1~3个月随访，仅2例表现为下肢静脉功能不全。结论：在THA术中及术后短期使用去氨加压素能有效减少患者的失血量和输血量。
[关键词] 去氨加压素；全髋关节置换术；患者；围术期；出血量
[中图分类号] R619 [文献标识码] A [文章编号] 1673-7210(2011)12(a)-062-03
Influence on blood loss and perioperative blood transfusion by desmopressin of the patients treated with total hip replacement.
YANG Hongfa
Department of Orthopedics, the People's Hospital of Dali City, Yunnan Province, Dali 671000, China
[Abstract] Objective: To investigate the influence of desmopressin (DDAVP) to the perioperative bleeding in patients with total hip arthroplasty (THA). Methods: 62 patients who were undergoing unilateral THA in our hospital from May 2008 to May 2010. The clinical data were analyzed retrospectively. All patients were divided into treatment group and control group using the method of random number table, each group had 31 cases respectively. The treatment group was given desmopressin accordance with 0.3 μg/kg dissolved in 100 ml normal saline, intravenous infusion once 30 min before operation and infused once per day at postoperation, continuous with 2 days, while the control group was supplied with equal amount of physiological saline. The comparison was made between two groups including blood loss, blood transfusion, postoperative drainage, preoperative and postoperative hemoglobin (Hb), hematocrit (Hct), platelets (Plt), fibrinogen (FIB), prothrombin time (PT) and activated partial thromboplastin time (APTT), and deep venous thrombosis was measured by color doppler ultrasound after the operation ......
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