摘要
目的探讨静脉联合局部应用氨甲环酸(TXA)减少髋关节翻修术围手术期中失血量的有效性和安全性。方法 2014年6月至2016年8月行髋关节翻修术的70例患者随机分为静脉联合局部应用氨甲环酸组与对照组,每组为35例。氨甲环酸组在手术前以10 mg/kg TXA+100 m L生理盐水静脉输注,并在手术中缝合切口时关节腔内注射1 g(1:10 m L)氨甲环酸,对照组采用同一时间注射相同剂量的生理盐水。记录患者术中出血量、输血量、术后引流量,在术后第2天复查患者血常规等指标,并将两组术后深静脉血栓形成的发生率和伤口并发症及住院天数相比较。结果应用静脉联合局部注射氨甲环酸组术中出血量、术后引流量及隐性失血量和输血量均低于对照组,差异有统计学意义(P<0.05)。但伤口并发症和术后深静脉血栓形成的发生率及住院时间两组间比较无统计学意义(P>0.05)。结论静脉联合局部应用氨甲环酸可明显减少全髋关节翻修术围手术期的失血量,并不会增加深静脉血栓形成的发生率。
Objective To discuss the efficacy and safety of the application of intravenous combined local tranexamic acid （TXA）, which reduces bleeding volume during a hip revision perioperative period. Method The 70 patients who had already undergone this surgery from June in 2014 to August in 2016 divided into intravenous combined topical application of tranexamic acid group and the control group randomly, 35 patients each group. Tranexamic acid group were infused 10 mg/kg TXA and 100 mL normal saline （NS） by venous infusion pre-operation, and infused 1 g TXA to articular cavity when suture incision. The control group were infused 100 mL normal saline in the same time. Record the patients’ amount of bleeding and blood transfusion volume during the operation and check the suction drainage and blood routine index the day after postoperation. Contrastive analyzes 2 groups the postoperative incidence of deep vein thrombosis and other complications and hospital stay. Results Tranexamic acid group amount of bleeding and blood transfusion volume during the operation and the hidden blood loss was lower than the control group, differences were statistical significance （P〈0.05）. There is no statistical significance in incidence of deep vein thrombosis, other complications and hospital stay（P〉0.05）. Conclusion Intravenous combined topical application of tranexamic acid can reduce the perioperative blood loss during the total hip revision perioperative period obviously, and won＇t raised the incidence of deep vein thrombosis.
作者
燕双喜
彭昊
陈森
Yah Shuangxi Peng Hao Chen Sen(Department ofjoint surgery, People＇s Hospital ofWuhan University Wuhan Hubei, 43006)
出处
《生物骨科材料与临床研究》
CAS
2017年第4期29-32,共4页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
氨甲环酸
全髋关节置换
静脉联合局部
失血
输血率
Tranexamic acid
Total hip replacement
Combined intravenous local
blood loss
Blood transfusion rate
