[1]刘湘钰,张新建,孙玉平,等.七氟烷对老年股骨颈骨折患者全髋关节置换术后凝血功能的影响[J].新乡医学院学报,2018,35(12):1073-1076.[doi:10.7683/xxyxyxb.2018.12.007]
　LIU Xiang-yu,ZHANG Xin-jian,SUN Yu-ping,et al.Effect of sevoflurane on blood coagulation function in elderly patients with femoral neck fracture after total hip arthroplasty[J].Journal of Xinxiang Medical University,2018,35(12):1073-1076.[doi:10.7683/xxyxyxb.2018.12.007]
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七氟烷对老年股骨颈骨折患者全髋关节置换术后凝血功能的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年12
页码:
1073-1076
栏目:
临床研究
出版日期:
2018-12-05

文章信息/Info

Title:
Effect of sevoflurane on blood coagulation function in elderly patients with femoral neck fracture after total hip arthroplasty
作者:
刘湘钰; 张新建; 孙玉平; 冯康平
（广州中医药大学第三附属医院麻醉科，广东　广州　510378）
Author(s):
LIU Xiang-yu; ZHANG Xin-jian; SUN Yu-ping; FENG Kang-ping
（Department of Anesthesiology，the Third Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510378，Guangdong Province，China）
关键词:
七氟烷; 股骨颈骨折; 老年人; 全髋关节置换术; 凝血功能
Keywords:
sevoflurane; femoral neck fractures; elderly; total hip arthroplasty; blood coagulation function
分类号:
R687.3
DOI:
10.7683/xxyxyxb.2018.12.007
文献标志码:
A
摘要:
目的　探讨七氟烷吸入麻醉对老年股骨颈骨折（FNF）患者全髋关节置换术（THA）后凝血功能的影响。方法　选择2015年1月至2017年12月广州中医药大学第三附属医院收治的100例FNF患者为研究对象，所有患者行单侧THA，根据麻醉方法分为七氟烷吸入麻醉组（七氟烷组） 和丙泊酚全凭静脉麻醉组 （丙泊酚组），每组50例。七氟烷组患者给予七氟烷吸入全身麻醉维持，丙泊酚组患者给予丙泊酚全凭静脉麻醉维持，比较2组患者手术前后凝血功能指标及术后深静脉血栓（DVT）发生率。结果　2组患者麻醉时间、手术时间、术中失血量及术后引流量比较差异均无统计学意义（P>0.05）。2组患者术前血小板（PLT）计数、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）及血浆D-二聚体（D-D）、纤维蛋白原（FIB）水平比较差异均无统计学意义（P>0.05）；2组患者术后第1、3、7天PLT计数及血浆D-D、FIB水平均高于术前（P<0.05），PT、APTT显著短于术前（P<0.05）；术后第1、3、7天，七氟烷组患者PLT计数及血浆D-D、FIB水平显著低于丙泊酚组（P<0.05），PT、APTT显著长于丙泊酚组（P<0.05）。七氟烷组和丙泊酚组患者术后DVT发生率分别为2.0%（1/50）、10.0%（5/50），七氟烷组患者术后DVT发生率显著低于丙泊酚组（χ2=6.847，P<0.05）。结论　七氟烷吸入麻醉可以有效改善老年FNF患者THA后凝血功能，降低FNF患者THA后DVT发生率。
Abstract:
Objective　To investigate the effect of sevoflurane inhalation anesthesia on blood coagulation function in elderly patients with femoral neck fracture （FNF） after total hip arthroplasty （THA）.Methods　One hundred patients with FNF in the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2015 to December 2017 were selected as the subjects.All patients underwent unilateral THA.The patients were divided into sevoflurane inhalation anesthesia group （sevoflurane group） and propofol total intravenous anesthesia group （propofol group） according to the anesthesia method，50 cases in each group.The patients in the sevoflurane group were performed with sevoflurane inhalation anesthesia，and the patients in the propofol group were performed with propofol total intravenous anesthesia.The blood coagulation function indexes before and after operation and the incidence of postoperative deep venous thrombosis （DVT） were compared between the two groups.Results　There was no significant difference in anesthesia time，operation time，intraoperative bleeding and postoperative drainage volume between the two groups （P>0.05）.There was no significant differences in platelet （PLT） counts，prothrombin time （PT），activated partial thromboplastin time （APTT） and the levels of plasma D-dimer （D-D），fibrinogen （FIB） between the two groups before treatment （P>0.05）.The PLT counts and plasma D-D,FIB levels at the 1st，3rd and 7th day after operation were higher than those before operation in the two groups （P<0.05），while PT and APTT were significantly shorter than those before operation （P<0.05）.On the 1st，3rd and 7th day after operation，the PLT counts and the levels of plasma D-D and FIB in the sevoflurane group were significantly lower than those in the propofol group （P<0.05），and PT and APTT in the sevoflurane group were significantly longer than those in the propofol group （P<0.05）.The incidence of DVT in the sevoflurane group and propofol group was 2.0% （1/50） and 10.0% （5/50），respectively after operation；the incidence of DVT in the sevoflurane group was significantly lower than that in the propofol group （χ2= 6.847，P<0.05）.Conclusion　Sevoflurane inhalation anesthesia can effectively improve the blood coagulation function of elderly patients with FNF after THA，and reduce the incidence of DVT in FNF patients after THA.

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更新日期/Last Update: 2018-12-05