硝酸甘油对全麻下髋关节置换术后深静脉血栓的影响  

Effect of nitroglycerin on deep venous thrombosis following total hip replacement under general anesthesia

作　　者：姚猛飞[1] 王秋兰[1] 毕建民[2] 姜雄华[1] 卢承志[1] 

机构地区：[1]中国人民解放军第一七五医院麻醉科,漳州市363000 [2]中国人民解放军第一七五医院超声科,漳州市363000

出　　处：《临床麻醉学杂志》2015年第7期652-654,共3页Journal of Clinical Anesthesiology

摘　　要：目的 探讨硝酸甘油对全麻下髋关节置换术后深静脉血栓（DVT）的影响。方法 选择实施人工全髋关节置换手术患者166例,男112例,女54例,年龄37-83岁,ASAⅡ或Ⅲ级。随机均分为硝酸甘油组和对照组,观察两组手术时间、术中出血量、输血例数与输血量;记录术前1d、术后1、3、7d的D-二聚体值（D-dimer）含量;记录彩色多普勒超声检查结果。结果 术后1、3d硝酸甘油组D-dimer含量明显低于对照组（P〈0.05）,硝酸甘油组术中出血量明显低于对照组（P〈0.05）,硝酸甘油组DVT发生率4例（4.8%）,明显低于对照组12例（14.5%）（P〈0.05）。结论 术中使用硝酸甘油控制降压预防全麻下髋关节置换术后深静脉血栓安全有效。Objective To evaluate the effectiveness and security of nitroglycerin-induced controlled hypotension on preventing deep venous thrombosis（DVT）following total hip replacement under general anesthesia.Methods One hundred and sixty-six patients following total hip replacement,male,112,female,54,aged 37-83 years,ASA Ⅱ orⅢ.They were randomly divided into nitroglycerin group and control group.peration time,blood loss,blood transfusion cases,and transfused blood transfusion volume were reocrded in both groups.The D-Dimer levels were determined preoperatively,and postoperatively on 1,3,7d.Color doppler ultrasound was used to detected the formation of DVT.Results The preoperative D-Dimer levels were in the normal range in two groups,then D-Dimer levels in nitroglycerin group were lower significantly 1,3dafter surgery,then declined gradually and close to normal level at postoperative 7d.Compared with the controlled group,the D-Dimer level in the nitroglycerin group was significantly lower at 1,3dafter surgery（P〈0.05）.The blood loss of the nitroglycerin group was lower than the controlled group（P〈0.05）,the incidence rate of DVT in the nitroglycerin group of 4（4.8%）was also lower than the controlled group of 12（14.5%）（P〈0.05）.Conclusion Nitroglycerin-induced controlled hypotension was effectly effective and safe on preventing deep venous thrombosis following total hip replacement.

关 键 词：深静脉血栓 硝酸甘油 髋关节置换 D-二聚体 

分 类 号：R614[医药卫生—麻醉学]