Baidu
map

Anesthesiology:氨甲环酸单次用药后持续输注在关节置换术中的作用

2017-12-01 王贵龙 “罂粟花”微信号

关节置换术患者术后第一天常存在大量的活化纤溶蛋白,术前使用抗纤溶药物氨甲环酸可减少出血。本研究探讨围术期额外剂量使用氨甲环酸是否会进一步减少出血。

背景与目的:关节置换术患者术后第一天常存在大量的活化纤溶蛋白,术前使用抗纤溶药物氨甲环酸可减少出血。本研究探讨围术期额外剂量使用氨甲环酸是否会进一步减少出血。

方  法:本研究为随机、双盲、前瞻性的对照研究,共纳入168名一侧髋关节置换术患者。试验组术前静脉注射1g氨甲环酸后,1g氨甲环酸8h内持续输注完毕,对照组持续输注安慰剂。主要结果为术后5天内累积出血量,次要结果为需要红细胞输注的患者人数。

结  果:实验组出血量平均值为919±338ml,而对照组为888±366ml,平均差值30ml(95%CI:-77~137;P=0.58);术后6周内,两组中均有3.6%的患者接受红细胞输注,试验组2名患者发生深静脉血栓;本实验数据结果与一项荟萃分析均显示围术期氨甲环酸的额外使用并不会产生增量效益。

结  论:术前氨甲环酸的使用及限制性输血策略的开展,减少了髋关节置换术患者围术期输血几率;但围术期额外剂量使用氨甲环酸并不会进一步减少患者出血量。

原始出处:

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2050967, encodeId=2a1c205096e9f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Jan 16 12:37:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742449, encodeId=ea221e4244925, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jun 01 05:37:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754182, encodeId=99d61e54182a7, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30135, encryptionId=7d3330135ac, topicName=关节置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=050736663344, createdName=apoenzyme, createdTime=Sat Sep 15 04:37:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576585, encodeId=967e15e65855f, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588288, encodeId=9d7e1588288a6, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2050967, encodeId=2a1c205096e9f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Jan 16 12:37:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742449, encodeId=ea221e4244925, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jun 01 05:37:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754182, encodeId=99d61e54182a7, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30135, encryptionId=7d3330135ac, topicName=关节置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=050736663344, createdName=apoenzyme, createdTime=Sat Sep 15 04:37:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576585, encodeId=967e15e65855f, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588288, encodeId=9d7e1588288a6, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=)]
    2018-06-01 yxch48
  3. [GetPortalCommentsPageByObjectIdResponse(id=2050967, encodeId=2a1c205096e9f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Jan 16 12:37:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742449, encodeId=ea221e4244925, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jun 01 05:37:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754182, encodeId=99d61e54182a7, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30135, encryptionId=7d3330135ac, topicName=关节置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=050736663344, createdName=apoenzyme, createdTime=Sat Sep 15 04:37:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576585, encodeId=967e15e65855f, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588288, encodeId=9d7e1588288a6, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2050967, encodeId=2a1c205096e9f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Jan 16 12:37:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742449, encodeId=ea221e4244925, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jun 01 05:37:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754182, encodeId=99d61e54182a7, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30135, encryptionId=7d3330135ac, topicName=关节置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=050736663344, createdName=apoenzyme, createdTime=Sat Sep 15 04:37:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576585, encodeId=967e15e65855f, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588288, encodeId=9d7e1588288a6, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2050967, encodeId=2a1c205096e9f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Jan 16 12:37:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742449, encodeId=ea221e4244925, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jun 01 05:37:00 CST 2018, time=2018-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754182, encodeId=99d61e54182a7, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30135, encryptionId=7d3330135ac, topicName=关节置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=050736663344, createdName=apoenzyme, createdTime=Sat Sep 15 04:37:00 CST 2018, time=2018-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576585, encodeId=967e15e65855f, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588288, encodeId=9d7e1588288a6, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 03 05:37:00 CST 2017, time=2017-12-03, status=1, ipAttribution=)]
    2017-12-03 skhzy

相关资讯

Lancet:氨甲环酸为产后出血最佳治疗药物

氨甲环酸可显着减少产后出血导致的妇女死亡,当产后出血发生时,应第一时间给予氨甲环酸

J Am Acad Dermatol:口服氨甲环酸治疗黄褐斑

目的:黄褐斑是亚洲人常见的一种色素性疾病,其治疗具有挑战性。口服氨甲环酸(TA)已经成为难治性黄褐斑一个潜在的治疗。但目前缺乏其安全性和有效性的大规模研究。我们试图评估口服TA对亚洲人口黄褐斑的治疗效果和不良影响。方法:对2010年1月-2014年6月在皮肤中心就诊接受口服TA的患者进行了回顾性分析。结果:研究共纳入了561例患者,其中91.4%为女性。治疗时间中位数为4个月。大多数患者(503

Lancet:延迟氨甲环酸抗纤溶药物治疗显著降低急性重症出血患者生存率

研究发现,急性严重出血是严重威胁患者生命的症状,片刻的延误都会导致氨甲环酸治疗效果显著降低

J Arthroplasty:全髋关节置换术,局部 VS.静脉注射氨甲环酸

已知氨甲环酸可减少全髋关节置换术围手术期失血。采用随机对照试验研究设计,共纳入了139名患者,分别接受2 g氨甲环酸局部应用或静脉注射。标准化术前和术后的方案。结果,与局部应用组患者相比 (160.3 [g] ± 63.8, 188.4 [g] ± 68.5; P = .014),静脉注射组患者血液和血红蛋白的损失量较低(1195.0 ± 485.9 mL, 1442.7 ± 562.7 mL;

Br J Clin Pharmacol:哪些因素决定外用氨甲环酸治疗全膝关节置换术后出血的疗效?

2017年7月,发表在《Br J Clin Pharmacol》的一项由中国科学家进行的研究考察了外用氨甲环酸治疗全膝关节置换术后出血的量化疗效。

NEJM:氨甲环酸治疗接受心脏手术患者,益处和风险并存

氨甲环酸降低了接受心脏手术患者的出血风险,但目前尚不清楚这是否会改善患者的预后。此外,人们还担忧氨甲环酸可能会有促血栓形成和致痫作用。在该项2×2析因设计的试验中,研究人员随机分配预计接受冠状动脉手术并且有围手术期并发症风险的患者接受阿司匹林或安慰剂,氨甲环酸或安慰剂。研究人员还报告了氨甲环酸比较的结果。主要结果是手术后30天内的死亡和血栓性并发症(非致死性心肌梗死,卒中,肺栓塞,肾衰竭或肠梗塞)

Baidu
map
Baidu
map
Baidu
map