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The Effects of Meloxicam on Blood Loss and Coagulation in Patients with Low Molecular Weight Herparin to Prevention DVT after Total Hip Replacement

Author: ZengZiRan
Tutor: LiaoZuo
School: Nanhua University
Course: Surgery
Keywords: total hip replacement DVT blood loss Meloxicamlow molecular weight heparin
CLC: R687.4
Type: Master's thesis
Year: 2012
Downloads: 28
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Abstract


Objective: To investigate the effects of Meloxicon on blood loss and coagula-tion in the patients with low molecular weight herparin for prevention of DVT aftertotal hip replacement,so as to provide the safety basis for postoperative pain treatmentafter total hip replacement.Methods:A prospective,randomized,controlled study had performed,accordingto the criteria of entry and removal,40patients undergoing total hip replacement weredivided into experimental group A and control group B randomly from2011.2to2012.1in the orthopaedics department.In the experimental group A every patient wasreceived low molecular weight herparin0.4ml IH once a day for14days whichbeginning at postoperative12hours to24hours and meloxicam15mg im once a dayfor5days after operation;in the control group B every patient was only received lowmolecular weight herparin heparin0.4ml IH once a day for14days which beginningat postoperative12hours to24hours. Two groups didn’t use any other drugs whichwould affect the coagulation. Postoperative antibiotics and other drugs, rehabilitationtraining were kept consistency in two groups. The blood routine,coagulation, werechecked in preoperative and postoperative one day, three days and five days for everycase,and stool occult blood test were checked for every case after operation. Theblood transfusion and hemorrhage were recorded during the observed time. Thecoagulation, Hb, RBC were compared for two groups.The rate of postoperative bloodtransfusion and occult blood were compared for two groups.The decrease in Hbfrom postoperative1day to3days and postoperative1day to5days were assessedfor the blood loss in two groups.Results:40cases were included in the study,20cases in the experimental group A,20cases in control group B,It showed no statistical differences in age, sex,preoperative disease, time of operation, amount of blood loss and transfusion inoperation, the type of prosthesis and other general information between twogroups.There were no statistically significant difference of Hb RBC between theexperimental group A and control group B at preoperative, postoperative oneday,three days and postoperative five days;The Hb, RBC of experimental groupA,control group B at postoperative one day, three days, five days were less than thatof the preoperative and it showed significant differences in two groups.The decreasein Hb from postoperative one day to three days were2.90±5.36g/L in group A and2.50±5.43g/L in group B, it showed no significant differences between two groups.The decrease in HB from postoperative1day to5days were2.50±6.18g/L in groupA and1.80±5.97g/L in group B,it showed no significant differences between the twogroups.The difference of PT APTT, Fb were not statistically significant between orwithin the experimental group A and control group B at preoperative, postoperativeone day、three days、five days. Blood transfusion occurred2cases in experimentalgroup A,1cases in control group B during the research,it showed no significantdifferences in blood transfusion rate between two groups. The OB（+） occurred3cases in experimental group A,2cases in control group B,it showed no significantdifferences in the rate of occult blood between two groups; no hemorrhagiccomplications happed in the two groups.Conclusion: A short-term application of meloxicam for pain treatment in thepatient with low molecular weight heparin for prevention of DVT after total hipreplacement does not increase the blood loss significantly and it has no significantimpact on the blood coagulation of APTT,PT,Fb,it provide the safety referential basisfor clinical application of anticoagulant and Meloxicon after total hip replacement.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Joint Surgery
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