摘要
目的探讨氨甲环酸关节腔内注射对全膝关节置换患者治疗效果的影响。方法前瞻性选取2017年1月至2018年12月承德医学院附属医院收治的需接受全膝关节置换术治疗的90例膝关节骨性关节炎患者,按照随机数字表法将患者平均分为两组,每组各45例。对照组患者仅接受常规全膝关节置换术治疗,研究组患者在对照组基础上进行氨甲环酸关节腔内注射治疗。观察两组患者的手术相关指标、实验室指标以及生活质量评分等。结果研究组患者的输血量(351.1±31.6 ml)、失血量(812.1±54.3 ml)以及引流量(240.1±45.7 ml)均低于对照组(479.4±32.4 ml,955.1±67.4 ml,452.1±67.3 ml),差异具有统计学意义(P<0.05);术后研究组患者的Hb水平(102.4±6.4 g/L)高于对照组(82.8±4.5 g/L),CRP水平(45.1±3.1 mg/L)低于对照组(56.2±1.5 mg/L),差异均具有统计学意义(P<0.05)。手术前后研究组患者的D-二聚体(0.73±0.0 mg/L)、纤维蛋白原(3.9±0.9 g/L)、凝血酶原时间(PT)(13.9±0.2 s)以及活化部分凝血活酶时间(APTT)(38.6±1.0 s)与对照组(0.720±.12 mg/L,3.8±0.9 g/L,13.9±0.2 s,38.6±0.9 s)比较,差异无统计学意义(P>0.05);研究组患者的生活质量总评分(719.6±16.7)高于对照组(516.3±17.2),差异具有统计学意义(P<0.05)。结论对于膝骨关节炎患者,相比常规全膝关节置换术治疗,在全膝关节置换术同时关节腔内注射氨甲环酸,可以有效降低患者手术出血量,降低患者术后贫血风险,提高患者生活质量,值得在临床中推广应用。
Objective To explore the effect of intra-articular injection of tranexamic acid on the amount of bleeding and quality of life(QOL)scores after total knee arthroplasty.Methods A total of 90 patients in knee arthroplasty group undergoing knee arthroplasty admitted to the affiliated hospital of Chengde Medical College during January 2017 to December 2018 were prospectively selected.According to the random number table method,these patients were divided into two groups,with 45 patients in each group.Patients in control group received conventional total knee replacement,and patients in study group received tranexamic acid intra-articular injection based on the treatment in control group.Surgical indicators,laboratory indicators and QOL scores of these two groups were observed and compared.Results The volume of blood transfusion(351.1±31.6 ml),volume of blood loss(812.1±54.3 ml)and drainage volume(240.1±45.7 ml)in patients of study group were lower than those of control group(479.4±32.4 ml,955.1±67.4 ml,452.1±67.3 ml),with statistically significant difference(P<0.05).Hb level(102.4±6.4g/L)in patients of study group was higher than that of control group(82.8±4.5 g/L),and CRP level(45.1±3.1mg/L)was lower than that of control group(56.2±1.5mg/L),with statistically significant difference(P<0.05).There was no significant difference(P>0.05)between study group and control group[(0.720±12 mg/L,3.8±0.9 g/L,13.9±0.2 s,PT(13.9±0.2 s)and APTT(38.6±1.0 s)].The total quality of life scores(719.6±16.7)in study group were higher than those of control group(516.3±17.2),and the difference was statistically significant(P<0.05).Conclusion For patients with knee osteoarthritis,in comparison with conventional total knee replacement,intra-articular injection of tranexamic acid during total knee replacement can effectively reduce the amount of operating bleeding,reduce the risk of postoperative anemia and raise the quality of life of patients,hence it is worthy to be promoted and applied in the clinical practice.
作者
徐飞
杨阳
王合围
邵天平
崔万勇
XU Fei;YANG Yang;WANG He-wei(Department of Joint Surgery,Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000,China)
出处
《临床和实验医学杂志》
2019年第21期2316-2319,共4页
Journal of Clinical and Experimental Medicine
基金
河北省卫健委课题(编号:20170878)
关键词
全膝关节置换术
氨甲环酸
关节腔内注射
出血量
生活质量
Total knee arthroplasty
Tranexamic acid
Intra-articular injection
Amount of bleeding
Quality of life
