| Project background： Current clinical workers of artificial jointreplacement with the thrombosis of lower limbs after further understanding andthe importance of improving, Variety of anticoagulant drugs, such as theordinary heparin, low molecular heparin, warfarin, etc. to appear in a certainextent, improved the incidence of postoperative deep vein thrombosis. But theseanticoagulant medicine has its own flaw and insufficient. Application ofanticoagulant drugs more professional and standardized application gradually.Direct factor Xa inhibitors-the laval shaaban made up for the inadequacy of therest of anticoagulant drugs. Objective: Observe shaaban prevent artificial kneeand hip replacement after lower limb deep vein thrombosis (DVT) and the effectof incision led traffic，So for a few hours after taking the sand cut class to makepreliminary guidance. Method: Retrospective analysis of61patients with kneeand hip replacements, The61patients of china-japan Union Hospital, JilinUniversity from October2011to September2012orthopaedic patients. Which iscut class to prevent unilateral hip, unilateral knee joint replacement. Dividedinto two groups: Group A8h postoperatively in patients with oral and cuttingclass10mg,1/d, for2weeks; Group B12h postoperatively in patients withoral and cutting class10mg,1/d, for2weeks. Group of61cases of in patientswith preoperative laboratory and color doppler history and related supportwithout a history of blood clots, two groups of patients before surgery has notbeen used any drugs influence on blood coagulation mechanism. Laboratoryexamination: the coagulation indexes of platelet (Plt), activated partialcoagulation live enzymes (APTT), prothrombin time (PT) results no obviousabnormality; Patients with preoperative liver function and renal functionexamination were not found obvious abnormality. Hip and knee replacement surgery anesthesia methods are based on general anesthesia, are performed bythe same set of orthopedic surgeons and anaesthetists same group. In this study61patients with Excel spreadsheet functions can be divided into two groups:31cases in group A patients,19cases of men, women,12cases; Age distribution in(60.5±7.3); Group B patients30cases,17cases of men and women in13cases; Age distribution in (61.2±7.5), the composition of two groups of patientsin the age and gender composition distribution ratio and so on various aspectsdifference is no statistical significance (P>0.05), comparable.24hours afterapplication of Cefuroxime Sodium for Injection (trade name: west force hin ofCefuroxime Sodium for Injection) to prevent infection treatment. After surgeryin patients with orthopaedic doctor necessary guided function of quadricepsexercises. Postoperative day3can help line device or crutch auxiliary necessarypart or the full weight of functional exercise on fields,3/d. Preoperative andpostoperative14D detection of two groups of platelet (Plt), activated partialthrombin live enzymes (APTT), prothrombin time (PT), preoperative andpostoperative1,3,7,14days draw venous blood determine D-dimer content,and observation of postoperative2D flow. Results: in group A patients theincidence of lower limb DVT was3.22%, B group of patients was3.33%, theincidence of DVT in group A and group B patients is no statistical significance(P>0.05). That felling shaaban in orthopaedic knee and hip replacement8hoursand12hours after drug treatment to prevent DVT. Group A patients complicatedwith hemorrhage in2cases,1case of incision bleeding,2days after theoperation, bleeding stopped after stopping anticoagulants.1cases ofsubcutaneous widespread petechial hemorrhage, stopping anticoagulants and nolonger bleeding after injection of vitamin K1, not bleeding phenomenon such asdigestive tract, urinary tract bleeding, not present difficulty breathing, chesttightness, etc. The clinical manifestations of pulmonary embolism. All patientswere recovered and discharged, follow-up for3~6months no DVT and PE. Two groups of operation indicators to compare group A and group B atpostoperative2hours incision drainage volume in comparison, difference hasstatistical significance (P <0.05). Laboratory results: group A and group Bpatients the Plt, APTT, PT and D-dimer content in joint replacement surgerybefore and after surgery, there was no statistical significance (P>0.05)difference comparison. Thus obtained two groups of anticoagulant drugs forblood clotting index effect is the same. So-called D-dimer it is a kind ofcrosslinked protein degradation after the specific product, its numerical heightcan react in a certain extent the fibrinolytic activity of the blood system. Becauseit has this feature, so you can as we measure the body state of fibrinolytic andfibrinolytic level between a molecular markers. Not only that, the plasma D-dimer in acute DVT content for us to meet the clinical diagnosis and has highersensitivity and clinical guidance[10]. This two groups of surgery in patients withpreoperative and postoperative period comparison there was no statisticallysignificant difference (P>0.05), so we can think that the sand cut class caneffectively reduce the postoperative blood plasma D-dimer level, so as toachieve the thrombosis has certain preventive effect. Postoperative2d led trafficboth in group A than group B, the difference was statistically significant (P <0.05), suggesting the laval shaaban in anticoagulation and at the same time,postoperative early risk taking has led to increase in the number of postoperative.Results: the two groups of patients with postoperative2d flow, in group A weresignificantly higher than group B drain flow, artificial knee and hip after12hours of oral shaaban incision of8hours after taking the cutting team less, noobvious difference was found between two groups formed to prevent DVT. |
PDF Full Text Request