摘要
目的探讨氨甲环酸对股骨近端防旋髓内钉(PFNA)治疗高龄患者转子间骨折隐性失血的影响。方法选取2011年6月~2016年7月我院收治的95例高龄转子间骨折患者并进行回顾性分析,经筛选后选中64例患者,依照是否使用氨甲环酸将其分为研究组与对照组,每组32例。研究组均采用PFNA方法予以固定骨折部位,手术切皮前10 min静脉滴注氨甲环酸1 g配入250 ml生理盐水的混合液。对照组在同样手术治疗的同时,在手术切皮前10 min静脉滴注250 ml生理盐水。术后5 d比较两组的总失血量、输入血量、显性失血量与隐性失血量。并于术后15 d对两组患者进行常规检查,证实下肢有无静脉血栓形成。结果研究组的总失血量、输入血量与隐性失血量显著少于对照组,差异有统计学意义(P<0.05)。两组的显性失血量比较,差异无统计学意义(P>0.05)。研究组患者未出现静脉血栓,对照组出现4例肌间静脉血栓,但未见其他部位血栓,血栓发生率为12.5%,两组的血栓发生率比较,差异有统计学意义(P<0.05)。结论氨甲环酸对PFNA治疗高龄患者转子间骨折隐性失血有明显降低作用,同时不会使转子间骨折患者术后产生血栓。
Objective To investigate the influence of Tranexamic Acid on recessive blood loss of proximal femoral nail anti-rotation （PFNA） in the treatment of intertrochanteric fractures of elderly patlents.Methods From June 2011 to July 2016,95 patients with intertrochanterie fractures in our hospital were retrospectively analyzed.After screening,64 pa tients were selected and the patients were divided into the study group and the control group according to whether the use of tranexamic acid,32 patients in each group.In the study group,PFNA method was used to fix the fracture site,and before skin incision 10 rain,mixture of Tranexamic Acid 1 g with 250 ml saline intravenous infusion were given.The control group was given the same surgical treatment at the same time,and before skin incision 10 rain,250 ml saline intravenous infusion were given.The total blood loss,blood volume,dominant blood loss and recessive blood loss were compared between the two groups after 5 d.And 15 d after surgery,patients of the two groups were given routine examination to confirm whether the lower limb venous thrombosis.Results The total blood loss,blood volume and recessive blood loss in the study group was lower than that in the control group,with significant difference （P〈0.05）.There was no significant difference between the two groups in the dominant blood loss （P〉0.05）.There were no venous thrombosis in the study group,and 4 cases of myenteric vein thrombosis occurred in the control group,but no thrombosis occurred in other parts,and the incidence rate of thrombosis was 12.5%.There was significant difference between the two groups in the incidence rate of thrombosis （P〈0.05）.Conclusion Tranexamic Acid has a significant decreased effect on the treatment of intertrochanteric fractures with PFNA in elderly patients,and does not cause thrombosis in patients with intertrochanteric fractures.
出处
《中国当代医药》
2017年第12期56-58,共3页
China Modern Medicine
关键词
氨甲环酸
股骨近端防旋髓内钉
转子间骨折
隐性失血
Tranexamic acid
Proximal femoral nail anti-rotation
Intertrochanteric fracture
Recessive blood loss
