摘要
背景:氨甲环酸在减少人工关节置换后出血方面的应用越来越多,但其使用方法及剂量仍存在争议,是近几年研究的热点。目的:观察静脉滴注联合局部应用氨甲环酸对减少初次全髋关节置换后隐性失血的有效性和安全性。方法:将65例初次全髋关节置换患者随机分为试验组与对照组。试验组患者于置换术中使用0.5 g氨甲环酸静脉滴注,缝合后经引流管推注0.5 g氨甲环酸,保留6 h;对照组给予生理盐水静脉滴注,缝合后经引流管推注50 m L生理盐水,保留6 h。对比两组患者的术中出血量、置换后显性失血及隐性失血量、疼痛评分、输血率、深静脉血栓形成情况及住院日。结果与结论:试验组置换后血红蛋白及红细胞压积均高于对照组(P<0.05),置换后显性失血及隐性失血量均低于对照组(P<0.05),输血率、住院日均少于对照组(P<0.05);而两组术中出血量、疼痛评分、深静脉血栓形成发生率差异无显著性意义(P>0.05)。提示全髋关节置换过程中静脉滴注联合经引流管内注射氨甲环酸能降低患者置换后显性、隐性失血量及输血率,并且没有增加下肢深静脉血栓形成的风险。
BACKGROUND： Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE： To investigate the efficacy and safety of intravenous drip combined with intra-articular injection of tranexamic acid on postoperative hidden blood loss in patients who received primary total hip arthroplasty. METHODS： Clinical data of 65 patients undergoing primary total hip arthroplasty were randomized to the test group and the control group. The patients in the test group received 0.5 g tranexamic acid through intravenous drip when the surgery starts and 0.5 g tranexamic acid inside hip joint through a drainage tube after capsule closure, and retaining for 6 hours. The patients in the control group intravenously received the same volume of physiological saline, and 50 m L physiological saline through a drainage tube after suture, and retaining for 6 hours. We compared with intraoperative blood loss, postoperative dominant blood loss and hidden blood loss, pain score, blood transfusion rate, deep vein thrombosis and day of hospitalization in both groups.RESULTS AND CONCLUSION： Hemoglobin and hematocrit were higher in the test group than in the control group after replacement（P〈0.05）. The volumes of dominant blood loss and hidden blood loss were lower in the test group than in the control group after replacement（P〈0.05）. Blood transfusion rate and day of hospitalization were less in the test group than in the control group（P〈0.05）. No significant difference in intraoperative blood loss, pain score and incidence of deep vein thrombosis was detectable between the two groups（P〈0.05）. These results indicate that the intravenous drip combined intra-articular injection of tranexamic acid in patients receiving total hip arthroplasty could reduce the amounts of postoperative dominant and hidden blood loss and blood transfusion rate, and did not increase the incidence of deep vein thrombosis.
出处
《中国组织工程研究》
CAS
北大核心
2015年第44期7071-7076,共6页
Chinese Journal of Tissue Engineering Research
基金
江苏省临床医学科技专项(BL2012002)
南京市科技计划项目(201402007)
中国医师协会骨科大手术术后血栓防治专项基金(20150214)
以上项目主管部门均为解放军南京军区南京总医院~~
