摘要
目的对比静脉滴注与关节腔内局部注射氨甲环酸对控制全膝关节置换术(TKA)失血量的有效性及手术安全性。方法将医院2012年1月至2014年10月收治的行全膝关节置换术患者73例随机分为静脉滴注组(对照组)40例和腔内使用组(治疗组)33例,其中静脉滴注组患者在麻醉诱导期使用氨甲环酸10 mg/kg,最大剂量1 g;腔内使用组患者术中关节囊缝合完成且止血带未放松前将氨甲环酸1g注入关节腔。结果腔内使用组术后总失血量较静脉滴注组明显减少(P<0.05),术后检测凝血功能(PT,APTT,INR)、深静脉血栓(DVT)发生率与静脉滴注组相比,差异有统计学意义(P>0.05);结论关节腔内注射氨甲环酸是一种能有效控制全膝关节置换术后失血量且较安全的方案,不增加术后深静脉血栓发生概率。
Objective To compare the effects and operative safety of intravenous drip and intra-articular cavity local injection of tranexamic acid on controlling blood loss volume in total knee arthroplasty. Methods Totally 73 patients with total knee arthroplasty treated in the hospital from January 2012 to October 2014 were randomly divided into the intravenous drip group（IVTA,contorl group, 40 cases） and the intra-articular use group（IATA,treatment group,33 cases）. The patients in the control group used intravenous tranexamic acid 10 mg/kg,with the maximum dose 1. 0 g during the anesthetic induction period,while the patients in the treatment group were intra-articularlly injected by tranexamic acid 1 g at the finishing of articular capsule suture and before relaxing the tourni-quet. Results The postoperative total blood loss volume in the control group was significantly decreased compared with that in the treatment group（ P 〈 0. 05）;there were no statistically significant differences in the postoperative coagulation function（PT,APTT,INR） and the incidence rate of deep venous thrombosis（DVT） between the two groups（ P 〉 0. 05）. Conclusion The intra-articular cavity injection of tranexamic acid is a safer scheme for effectively controlling postoperative blood loss volume without increasing the occur-rence probability of postoperative DVT.
出处
《中国药业》
CAS
2015年第12期44-46,共3页
China Pharmaceuticals
关键词
全膝关节置换术
氨甲环酸
局部注射
静脉滴注
凝血功能
深静脉血栓
total knee arthroplasty
tranexamic acid
local injection
intravenous drip
coagulation function
deep venous thrombosis
