低分子肝素对关节置换术患者术中血液流变学及凝血的影响

The Effect of Low Molecular Heparin to Intraoperatie Blood Rheology and Coagulation in Patients with Joint Replacement

目的探讨并分析在全麻下低分子肝素对关节置换术术中血液流变学及凝血功能的影响,并对其临床价值进行评价。方法随机选取该院2012年7月—2013年11月期间收治的60例需行关节置换术的患者,采用随机分组的方式,将患者平均分成观察组和对照组,对照组采取常规处理,包括术前肌注肌注鲁米那钠、托品等,常规建立静脉通道与生命体征检测等,在此基础上对观察组患者行低分子肝素处理。对术中的流血量、输液量和手术时间做好详细的记录。结果与对照组相比,观察组患者在注药后1 h和2 h的血沉方程K值、血还原粘度、全血粘度、RBC电泳指数和RBC聚集指数都要低得多,差异有统计学意义(P<0.05),术中手术时间、输液量和失血量两组患者,差异无统计学意义(P>0.05)。结论在患者全麻状态下使用低分子肝素能够有效的提高关节置换术术中血液流变学的状态,并且手术安全有效,值得借鉴并推广。

Objective To study and analyze the effect of low molecular heparin to intraoperatie blood rheology and coagulation in patients with joint replacement under general anesthesia and evaluate its clinical value. Methods From July 2012 to November2013 selected 50 patients who required joint replacement in our hospital. According to the method of random grouping, the patients were divided into observation group and control group on average. The control group take normal processing, including preoperative muscle intramuscular injection of sodium luminal and atropine, with conventional intravenous and vital signs, etc. On this basis, patients in the observation group accept low molecular heparin treatment. Collect the amount of bleeding in the operation,operation time and quantity of the infusion to do detailed records. Results Compared with control group, the observation group of patients after drug 1 h and 2 h of blood sedimentation equation K value, blood reduction viscosity, whole blood viscosity, RBC electrophoresis index and RBC aggregation index were much lower（P〈0.05）, and the differences of the amount of intraoperative operative time, transfusion and blood loss of the two group had no significant statistical significance（P〈0.05）. Conclusion Using low molecular heparin in patients with general anesthesia condition can effectively improve the state of hemorheology in joint replacement surgery, and surgery is safe and effective, and it is worth reference and promotion.