低分子肝素钙与NSAIDs联合应用对于游离皮瓣术后出血量的影响  

The effect of low molecular weight heparin calcium combined with NSAIDs on postoperative bleeding of free flap

作　　者：杜晓龙 史少岩 龙佳丰 段虹昊[1] 胡东[1] 郑前进 欧学海 Du Xiaolong;Shi Shaoyan;Long Jiafeng(Ward 1,Hand Center,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院手外中心一病区,710054

出　　处：《美中国际创伤杂志》2023年第2期3-5,共3页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨低分子肝素钙与NSAIDs联合应用对于游离皮瓣术后出血的影响,提高游离皮瓣成活率。方法:选取2016年1月至2017年1月我院同一医疗小组行游离股前外侧皮瓣移植术患者54例,随机分为A组:低钙+双氯芬酸钠组(18例);B组:单独使用双氯芬酸钠组(18例);C组:单独使用低钙组(18例),其他用药相同。术后常规换药,观察敷料渗血情况,估计出血量,并监测血常规,必要时给予输血、补液治疗。比较三组患者出血量、血管危象、皮瓣成活率情况,结果使用配对t检验进行统计分析。结果:A组、B组和C组出血量平均为452ml,187ml和201ml(A组VSB组,P<0.05A组VSC组,P<0.05;B组VSC组,P>0.05);各组出现血管危象的例数为3例、1例和0例;各组皮瓣成活率均为88.9%、99.4%和100%。结论:低分子肝素钙与NSAIDs联合应用增加了游离皮瓣术后的出血量,血肿压迫血管蒂,形成血管危象,临床上不建议联合使用。Objective:To investigate the effect of low molecular weight heparin calcium(lmwh)combined with NSAIDs on postoperative bleeding of free flap and to improve the survival rate of free flap.Methods:From January 2016 to January 2017,54 cases of anterolateral femoral free flap transplantation were selected from the same medical group in our hospital.They were randomly divided into group A:low calcium plus diclofenac sodium group(18 cases);Group B:diclofenac sodium group alone(18 cases);Group C:Low calcium group alone(18 cases),other drugs were the same.Affer the operation,the dressing was changed routinely,the blood oozing from the dressing was observed,the amount of bleeding was estimated,and the blood routine was monitored.The blood loss,vascular crisis and skin flap survival rate were compared among the three groups and the results were analyzed by paired t-test.Results:The average amount of bleeding in group A,group B and Group C was 452ml,187ml and 201ml respectively(Group A vs B,P<0.05;Group A vs C,P<0.05;Group B vs C,P>0.05),vascular crisis were 3,1 and 0 cases,and the survival rates of all flaps were 88.9%,99.4%and 100%in each group.Conclusion:The use of low molecular weight heparin calcium combined with NSAIDs can increased the amount of bleeding after free flap operation,and the hematoma pressed the vascular pedicle to form the vascular crisis.The combination of low molecular weight heparin calcium and NSAIDs is not recommended clinically.

关 键 词：游离皮瓣 低分子肝素钙 NSAIDS 出血量 

分 类 号：R47[医药卫生—护理学]