摘要
目的:研究人工全髋关节置换术中创口滞留氨甲环酸注射液对术后失血量的影响。方法:选取齐齐哈尔市中医医院2014年9月至2015年12月行老年股骨颈骨折患者初次人工全髋关节置换术患者60例,其中治疗组(TXA)30例术中创口滞留使用氨甲环酸注射液20mg/kg,对照组30例术中滞留生理氯化钠注射液,对比两组术后总失血量、术中出血量、术后引流血量、隐性失血量、凝血酶原时间(PT)、活化部分凝血酶时间(APTT),凝血酶时间(TT),术后14d内下肢静脉血栓发生、创口渗血和瘀斑等指标。结果:两组患者术中出血量、隐性失血量差异无统计学意义(P>0.05),总失血量、术后引流血量,TXA组明显少于对照组,差异有统计学意义(P<0.05);术后PT,APTT,TT比较差异均无统计学意义(P>0.05),超声检查所有患者均无下肢深静脉血栓(DVT)形成,无肺栓塞(PE)的发生,而TXA组创口渗血及瘀斑形成明显少于对照组。结论:氨甲环酸注射液术中创口内滞留给药能有效减少老年股骨颈骨折患者初次人工全髋关节置换术后失血量、创口渗血及周围瘀斑的发生,并不增加血栓形成风险。
Objective：To study curative effect on blood loss of elderly patients with femoral neck fracture by tranexamic acid detained in the wound during total hip arthroplasty（THA）. Methods：Sixty eldly patients who received primary unilateral THA from September 2014 to December 2015 were enrolled. Among them, 30 cases were in the tranexamic acid group, 30 cases with-out use of tranexamic acid were as control. In tranexamic acid group, 20 mg /kg of tranexamic acid was infused in the wound, and patients in control group were not. Total blood loss, postoperative drainage, hidden blood loss, prothrombin time（PT）and activated partial thromboplastin time（APTT）were recorded and compared between the two groups. Complications were analyzed when postoperative 14 d（ the lower limb venous thrombosis was checked by ultrasound）.Results：There were significant differences between two groups about total blood loss, postoperative drainage（P〈0.05）.There was no significant difference between two groups about hidden blood loss, PT and APTT（P〉0.05）. Deep vein thrombosis was not found by ultrasound after operation. Conclusion：The use of tranexamic acid can significantly decrease postoperative blood loss, errhysis and ecchymosis around the wound without increasing the risk of thrombosis in patients with THA.
出处
《中国中医骨伤科杂志》
CAS
2017年第4期31-34,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
氨甲环酸
滞留
全髋关节置换术
失血
tranexamic acid
detain
total hip arthroplasty
blood loss
