| Abstract:Objective:As the material in living standards improve, Elderly patient asked for the joint operation will be more and more. The age of physical changes would result in the postoperative complications, more likely one of the clot formed in more than60%. At present over its more than prevention methods, such as use of Heparins after primary hip replacementsurgery used in Heparins change its hemorheology so as to reach deep venous thrombosis prevention methods formed research less coverage. So this is the purpose of research on general anesthesia by the use of low-moleular heparin to prevent deep venous thrombosis during primary hip replacement surgery into the feasibility of blood clots. Methods:30patients(male17,female13,aged50-70years old),with THR were treated elective radical surgery. Randomly divided into group A(saline water, n=10)、group B (lOu/kg LMWH n=10)、group C (20u/kg LMWH n=10). Thirty patienys with Selecting THR under general anesthesia were Randomly divided into group A、group B、group C, and0.2ml normal saline or0.2ml (lOu/kg LMWH) or0.2ml (20u/kg LMWH) were respectively subcutaneous injected at lateral abdominal wall between post-anesthesia and pre-operation. Anesthesia procedures: imidazole alprazolam0.04mg/kg, fentanyl2ug/kg, propofol2mg/kg, vecuronium0.1mg/kg were intravenous injected successively for rapid induction, followed by endotracheal intubation, Ohmeda80-type anesthesia machine was used to control breathe. propofol8mg/(kg.h), remifentanil0.05-0.2ug/(kg.min) and vecuronium lug/(kg.min) were intravenous pumped to maintain anesthesia, adlusting the dosage according to blood pressure and heart rate. Uniform application of lactate Ringers’s solution and6%of hypdroxyethyl starch(ratio of2:1) for intraoperative transfusion at the speed of10-15ml/(kg.h),4ml blood were drawn respectively in all patients at four time points:before the infusion of anesthesia (TO),1h(T1)、3h(T2) and24h(T3)after injection to measure hematocrit. Fast automatic Blood test instrument was used to measure the high-shear whole blood viscosity (Hηb),the middle-shear whole blood viscosity(Mηb), low-shear whole blood viscosity(Lηb),and plasma viscosity(ηp).Applicating FASCO-3010blood rheological analysis software to restore the calculation of whole blood viscosity(ηr), erythrocyte aggregation index(EAI),red blood cell deformability index(EDI),erythrocyte rigidity index(ERI)and (EPT). Results:(1) anesthesia before surgery(TO) the values of Hηb, Mηb, Lrjb, ηp, ηr, EAI,EDI,ERI and EPT among the three groups showed no statistical difference.(2)1h after injection(T1), in group A,about Hrjb,Lηb and EPT,compared with T0,the value in Tl significantly decreased(p<0.05). in group B, about Hηb,Lηb,ηr and EPT,compared with T,the value in T1significantly decreased (p<0.05); about Lηb,ηr,EPT, compared with Tl,the value in T2significantly decreased (p<0.05); abou ηr,EPT, compared with Tl,the value in T3significantly increased (p<0.05). in group C, about Hηb,Mηb,Lηb,ηp,ηr,EAI,ERI and EPT,compared with T0,the value in T1significantly decreased (p<0.05); about Hηb,Lηb,ηr,EAI,EPT,compared with Tl,the value in T2significantly decreased (p<0.05); about Hηb, Lηb, ηp, ηr, ERI, EPT, compared with Tl,the value in T3significantly increased (p<0.05. about Hηb,Lrjb,rjr,EPT,compared with A,the value in B,C significantly decreased, the values of ηp,ERI between A and B showed no statistical difference; the values of EAI,EDI among the three groups showed no statistical difference.(3)3h after injection(T2), in group A, about Hηb,EPT,compared with T0,the value in T2significantly decreased (p<0.05). in group B, about Hηb,Lηb,ηp,ηr,EAI,ERI and EPT,compared with T0,the value in T2significantly decreased (p<0.05); about Hηb,Lrjb,ηr,ERI,EPT,compared with T2,the value in T3significantly increased (p<0.05). in group C, about Hηb, Mηb, Lηb, ηp, ηr, EAI, ERI,EPT,compared with T0,the value in T2significantly decreased (p<0.05); about Hηb,Mηb,Lηb,ηp,ηr,ERI and EPT,compared with T2,the value in T3significantly increased(p<0.05)。T2about Hηb, Lηb, ηp, ηr, EAI,ERIand EPT,compared with A,the value in B,C significantly decreased, about Hηb, Lηb, ηp, ηr, EAI, ERIand EPT, compared with B,the value in C significantly decreased;the values of Mηb, EDI between A and B showed no statistical difference; about Mηb, EDI,compared with A,the value in C significantly decreased.(4)24h after injection(T3), in group A, about Hηb,EPT,compared with T0,the value in T3significantly decreased (p<0.05)。in group B, about Hηb,Lηb,EPT,compared with T0,the value in T3significantly decreased (p<0.05).in group C, about Hηb,Mηb,Lηb,ηr,EAI and EPT,compared with T0,the value in T3significantly decreased(p<0.05). The values of Hηb, Mηb, rjp, EAI, EDI, ERI and EPT among the three groups showed no statistical difference, about Lηb,ηr,compared with A,the value in B,C significantly decreased. Conclusions:(1) Trace quantities are of lower tension in the art of skin-poping can greatly improve the blood stream denatured(2) Low molecular weight heparins improvement for blood Flow denatured dose-related... |
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