摘要
背景:有研究表明氨甲环酸能够有效减少全膝关节置换术患者的术后出血量,但是氨甲环酸的给药方式有多种,包括关节腔注射,静脉注射和两者联合用药,但效果尚无定论。目的:探讨关节腔注射,静脉注射和两者联合用药3种氨甲环酸给药方式是否能够有效的减少全膝关节置换后出血。方法:试验选择2014年12月到2015年12月进行单侧全膝关节置换术的患者103例,根据氨甲环酸的给药方式不同随机分为4组:关节腔注射组术中膝关节切口缝合后给予关节腔注射液2 000 mg氨甲环酸;静脉注射组在止血带使用前15 min静脉注射1 000 mg氨甲环酸;联合治疗组采用上述2种方法联合干预;空白对照组不采用氨甲环酸干预。结果与结论:1总出血量和输血率:关节腔注射组和联合治疗组的总出血量和输血率均少于静脉给药组(P<0.05),且关节腔注射组总出血量略多于联合治疗组,但差异无显著性意义(P>0.05),两组输血率均为0%;2不良反应:各组中均未出现深静脉血栓、肺部血栓、切口感染、血肿和坏疽等不良反应;3结果证实:氨甲环酸关节腔给药联合静脉给药可有效减少全膝关节置换后出血,效果略优于单独给药。
BACKGROUND：Studies have shown that tranexamic acid can effectively reduce postoperative blood loss in patients with total knee arthroplasty.There are many means to inject tranexamic acid（intra-articular injection,intravenous injection and their combination）.Which is the best way has no conclusion.OBJECTIVE：To explore whether all three ways（intra-articular injection,intravenous injection and their combination） to inject tranexamic acid can all effectively reduce the bleeding after total knee arthroplasty.METHODS：103 patients undergoing unilateral total knee arthroplasty from December 2014 to December 2015 were enrolled in this study.The patients were allocated into four groups according to injection way.In the intra-articular injection group,2 000 mg of tranexamic acid was given through the intra-articular injection after incision suture.In the intravenous injection group,1 000 mg of tranexamic acid was given through the intravenous injection at 15 minutes before the use of tourniquet.In the combined modality therapy group,above methods were used.In the blank control group,tranexamic acid was not given.RESULTS AND CONCLUSION：（1） Total blood loss and blood transfusion rate were less in the intra-articular injection group and combined modality therapy group than in the intravenous injection group（P〈0.05）.The total blood loss was more in the intra-articular injection group than in the combined modality therapy group（P〈0.05）.The blood transfusion rate was 0% in the intra-articular injection group and combined modality therapy group.（2） Adverse reaction：deep vein thrombosis,pulmonary embolism,wound infection,hematoma or gangrene was not observed in all groups.（3） Results confirmed that intra-articular combined with intravenous injection can reduce effectively postoperative blood loss and the effect is better than separate administration.
出处
《中国组织工程研究》
CAS
北大核心
2016年第17期2437-2442,共6页
Chinese Journal of Tissue Engineering Research
基金
the National Natural Science Foundation of China,No.81141078~~
