摘要
目的探讨氨甲环酸在全膝关节置换术中不同时间应用的止血效果差异。方法选取2014年1月至2016年8月期间本院骨科全膝关节置换术患者120例,采用随机数字表法将患者分为两组,观察组松止血带前0.5 h静脉滴注100 ml氨甲环酸;对照组松止血带时静脉滴注100 ml氨甲环酸。比较两组失血量、术后引流量、输血量、实验室指标[血红蛋白(hemoglobin,Hb)、红细胞比容(hematocrit,HCT)、D二聚体(D-dimer,D-D)、活化部分凝血活酶时间(activated partial thromboplastin time,aPTT)、凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,Fbg)]与药物安全性的差异。结果与对照组比较,观察组显性失血量、隐性失血量、总失血量、术中失血量、术后引流量与输血量均明显减少,P<0.05。观察组输血率为21.67%(13/60),明显低于对照组41.67%(25/60),P<0.05。手术后,观察组Hb、HCT水平明显高于对照组,P<0.05,但两组D-D、aPTT、PT与Fbg水平比较差异无显著性(P>0.05)。两组患者伤口均Ⅰ期愈合,未出现严重并发症。结论氨甲环酸松止血带前0.5 h应用有助于明显改善全膝关节置换术患者的止血效果,降低输血率,且不同时间应用不影响凝血功能。
Objective To study the hemostatic effect difference of tranexamic acid application in different time during total knee arthroplasty. Methods 120 cases of total knee arthroplasty from Orthopedics Department of our hospital during the period of January 2014 and August 2016 were selected, the patients were divided into two groups by using the random number table method, observation group were given 100 ml tranexamic acid intravenous drip before 0. 5 h of loosing tourniquet,the control were given 100 ml tranexamic acid intravenous drip when loosing tourniquet. The difference of blood loss, amount of post- operation drainage, blood transfusion amount, laboratory index [ hemoglobin （ Hb ）, hematocrit （ HCT ）, D- dimer （ D- D ）, Activated partial thromboplastin time （aPTF）, prothrombin time （ffF）, fibrinogen （Fbg） ] and drug safety between the two groups were compared. Results Compared with control group, dominant blood loss and hidden blood loss, total blood loss, intra-operative blood loss, amount of post-operation drainage and blood transfusion amount of the observation group were significantly reduced,P 〈 0. 05. The blood transfusion rate of observation group was 21.67% （ 13/60）, was significantly lower than the control group 41.67% （25/60）, P 〈 0.05. After operation, Hb,HCT levels of observation group was obviously higher than that of control group, P 〈 0. 05, but D- D, aFFF, PT Fbg levels compared between the two groups with no significant difference （P 〉 0.05 ）. The wound of two groups patients were I healing, had no serious complications. Conclusion Tranexamie acid application before 0. 5 h of loosing tourniquet helps to significantly improve hemostatic effect for total knee arthroplasty, decrease blood transfusion rate, and different time application does not affect blood coagulation function, it is worthy of clinical popularization and application.
出处
《血栓与止血学》
2017年第4期612-615,共4页
Chinese Journal of Thrombosis and Hemostasis
关键词
氨甲环酸
全膝关节置换术
应用时间
止血
Tranexamic acid
Total knee arthroplasty
Application time
Hemostatic
