血凝酶对髋关节置换术低分子肝素抗凝患者出血量及凝血功能的影响

目的:观察注射用血凝酶对髋关节置换术低分子肝素抗凝患者术中出血量及凝血功能的影响。方法:选取收治的髋关节置换术的患者共161例,采用双盲、随机的方法分为实验组83例和对照组78例,所有患者均为我院收治的行髋关节置换术的病例。对照组采用术前给予低分子肝素处理,观察组患者术前给予注射用血凝酶及低分子肝素处理。术后对两组患者术中出血量、术后24 h引流量、术后24 h红细胞(RBC)、血红蛋白(Hb)、纤维蛋白原(Fib)、术后24 h部分凝血活酶时间(APTT)、凝血酶原时间(PT)等情况进行分析。结果:实验组患者术中出血量、术后24 h引流量值均低于对照组,且差异有显著性(P0.05)。两组患者术后24 h红细胞RBC、血红蛋白Hb均下降,但是组间比较差异无统计学意义(P0.05)。术后纤维蛋白原Fib值均上升,组间比较差异无统计学意义(P0.05)。实验患者术后24 h部分凝血活酶时间APTT、凝血酶原时间PT均较术前有所降低,但是于术前及组间比较差异无统计学意义(P0.05)。结论:全髋置换术中使用注射用血凝酶不受低分子肝素的抑制,且安全有效,值得临床进一步研究和应用。

Effects of Hemocoagulase on Blood Loss and Blood Coagulation of Patients with Low Molecular Weight Heparin During Hip Replacement Surgery

Objective:To observe the effect of Hemocoagulase on the amount of bleeding and blood coagulation of patients with low molecular weight heparin during hip replacement surgery.Methods:161 cases of patients were divided by double-blind, randomized method into experimental group (83 cases) and control group (78 cases). All patients had hip joint replacement surgery in our hospital. Before surgery, patients in control group were given low molecular weight heparin, while patients in experimental group were given hemocoagulase and low molecular weight heparin. After surgery, such indicators were analyzed as the intraoperative blood loss, 24 h postoperative drainage, 24 h postoperative red blood cell (RBC), hemoglobin (Hb), fibrinogen (Fib), 24 h postoperative partial thromboplastin time (APTT), coagulation zymogen time (PT) and so on.Results:The intraoperative blood loss and 24 h postoperative drainage of patients in the experimental group were lower than in the control group, and the differences were statistically significant(P<0.05). The 24 h postoperative RBC, hemoglobin Hb decreased in patients of both groups, but the difference between two groups was not statistically significant (P>0.05) between groups. Postoperative fibrinogen Fib values increased, but had no statistical difference between the two groups (P>0.05). In the experimental group, the 24 h postoperative APTT and PT decreased as compared with before surgery, but there was no statistical difference between before and after surgery and between groups (P>0.05).Conclusion:Patients treated with total hip arthroplasty plus hemocoagulase suffered no inhibition of low molecular weight heparin. Total hip arthroplasty plus hemocoagulase treatment was safe and effective, and was worthy of further research and application.