实用医学杂志
實用醫學雜誌
실용의학잡지
The Journal of Practical Medicine
2015年
18期
2966-2968,2969
,共4页
周智%熊亚琼%谢跃%王黎明
週智%熊亞瓊%謝躍%王黎明
주지%웅아경%사약%왕려명
全膝关节置换%脉冲%自体血液回输%肿瘤坏死因子-α%白介素-6%D-二聚体
全膝關節置換%脈遲%自體血液迴輸%腫瘤壞死因子-α%白介素-6%D-二聚體
전슬관절치환%맥충%자체혈액회수%종류배사인자-α%백개소-6%D-이취체
Total knee arthroplasty%Pulse%Autologous blood transfusion%Tumor necrosis factor-α%Interleukin-6%D-dimer
目的：观察术中脉冲冲洗联合术后自体血回输，对膝关节置换手术凝血、炎症、血栓指标的影响，并与单用术后自体血回输的对照组进行比较。方法：选取因膝关节骨性关节炎行单侧人工全膝关节置换术患者96例，随机分成实验组（术中脉冲冲洗联合术后自体血回输）和对照组（单用术后自体血回输组），检测对比不同时点两组的PT、APTT、TNF-α、IL-6、D-D 值，并术后行下肢血管彩超检查。结果：两组患者术后的PT、APTT值比较差异无统计学意义（P ＞0．05），实验组术后第1、7天的TNF-α、IL-6值均低于对照组，差异有统计学意义（P ＜0．05），实验组术后第4天的D-D 值均低于对照组，差异有统计学意义（P ＜0．05），实验组下肢DVT的发生率低于对照组（P ＜0．05）。结论：全膝关节置换术中脉冲冲洗联合术后自体血回输对凝血功能无影响，且较单用自体血回输可以减轻炎症、减少深静脉血栓的发生，故对患者恢复有益。
目的：觀察術中脈遲遲洗聯閤術後自體血迴輸，對膝關節置換手術凝血、炎癥、血栓指標的影響，併與單用術後自體血迴輸的對照組進行比較。方法：選取因膝關節骨性關節炎行單側人工全膝關節置換術患者96例，隨機分成實驗組（術中脈遲遲洗聯閤術後自體血迴輸）和對照組（單用術後自體血迴輸組），檢測對比不同時點兩組的PT、APTT、TNF-α、IL-6、D-D 值，併術後行下肢血管綵超檢查。結果：兩組患者術後的PT、APTT值比較差異無統計學意義（P ＞0．05），實驗組術後第1、7天的TNF-α、IL-6值均低于對照組，差異有統計學意義（P ＜0．05），實驗組術後第4天的D-D 值均低于對照組，差異有統計學意義（P ＜0．05），實驗組下肢DVT的髮生率低于對照組（P ＜0．05）。結論：全膝關節置換術中脈遲遲洗聯閤術後自體血迴輸對凝血功能無影響，且較單用自體血迴輸可以減輕炎癥、減少深靜脈血栓的髮生，故對患者恢複有益。
목적：관찰술중맥충충세연합술후자체혈회수，대슬관절치환수술응혈、염증、혈전지표적영향，병여단용술후자체혈회수적대조조진행비교。방법：선취인슬관절골성관절염행단측인공전슬관절치환술환자96례，수궤분성실험조（술중맥충충세연합술후자체혈회수）화대조조（단용술후자체혈회수조），검측대비불동시점량조적PT、APTT、TNF-α、IL-6、D-D 치，병술후행하지혈관채초검사。결과：량조환자술후적PT、APTT치비교차이무통계학의의（P ＞0．05），실험조술후제1、7천적TNF-α、IL-6치균저우대조조，차이유통계학의의（P ＜0．05），실험조술후제4천적D-D 치균저우대조조，차이유통계학의의（P ＜0．05），실험조하지DVT적발생솔저우대조조（P ＜0．05）。결론：전슬관절치환술중맥충충세연합술후자체혈회수대응혈공능무영향，차교단용자체혈회수가이감경염증、감소심정맥혈전적발생，고대환자회복유익。
Objective To explore the effect of pulse irrigation combined with autologous blood transfusion on inflammatory markers and thrombosis index, such as C-reactive protein (CPR), erythrocyte sedimentation rate (ESR), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients undergoing total knee arthroplasty. Methods 96 patients due to knee osteoarthritis underwent unilateral total knee arthroplasty were randomly divided into experimental group (pulse irrigation combined with autologous blood transfusion after surgery ) and control group (alone autologous blood transfusion after surgery), PT, APTT, TNF-α, IL-6, D-Dimer of two groups at different time points were detected and compared. All patients underwent lower extremity vascular ultrasound examination after operation. Results PT, APTT values were no significant different between two groups (P > 0.05), TNF-α, IL-6 values of day1 and day7 after surgery in the experimental group were lower than the control group(P < 0.05), D-Dimer values of day4 after surgery were lower than the control group (P <0.05), the incidence of deep vein thrombosis (DVT) in the experimental group was lower than the control group (P < 0.05). Conclusion Pulse irrigation combined with postoperative autologous blood transfusion in total knee arthroplasty had no influence in blood coagulation , and can reduce inflammation and the incidence of DVT than alone autologous blood transfusion,thus is beneficial to the patient recover.
