摘要
目的探讨氨甲环酸单纯局部应用对老年股骨颈骨折患者行全髋关节置换术(THA)后失血量及输血率的影响。方法回顾性分析因股骨颈骨折在本院行单侧THA的60例患者的临床资料,根据术中有无局部使用氨甲环酸分为2组。氨甲环酸组30例患者术中局部应用氨甲环酸170 mL冲洗浸泡,对照组30例患者术中不使用氨甲环酸。所有患者夹管6 h后接引流袋,术后24 h拔除引流管。比较2组输血率,记录术中出血量、术后引流量、并发症情况及术后第1、3天血红蛋白(Hb)及平均红细胞压积(MCV)水平。结果氨甲环酸组输血率为3.33%,低于对照组的36.67%,术后24 h引流量为(130.00±63.03)mL,小于对照组的(264.33±141.23)mL,差异均有统计学意义(P<0.05);氨甲环酸组术后第1、3天Hb及MCV均高于对照组,差异有统计学意义(P<0.05)。2组术后第1天Hb的丢失量差异有统计学意义(P<0.05),术后第3天Hb丢失量比较,差异无统计学意义(P>0.05)。2组患者术后均无深静脉血栓形成、肺部感染、切口感染等并发症发生。结论老年股骨颈骨折患者行THA术中单纯局部应用氨甲环酸可明显降低输血率,减少术后引流量和隐性失血量,同时不会增加并发症发生风险。
Objective To investigate the effect of local application of tranexamic acid on blood loss and transfusion rate of patients with femoral neck fractures after undergoing total hip arthroplasty(THA).Methods The data of 60 femoral neck fracture cases underwent unilateral THA in our hospital was retrospectively studied,and these patients were divided into two groups according to whether tranexamic acid was locally applied or not.The tranexamic acid group(n=30)was locally bathed with 170 mL tranexamic acid during the operation,while the control group(n=30)used no tranexamic acid during operation.The drainage packs were not allowed to connect with the drainage tubes until the tubes were clamped for 6 hours,and the drainage tubes were removed at 24 h after the operation.Blood transfusion rates were compared between the two groups.Intraoperative blood loss,postoperative drainage volume,occurrence of complications,hemoglobin(Hb)level and mean corpuscular volume(MCV)on the first day and third day after operation were recorded.Results The transfusion rate was 3.33%in the tranexamic acid group,which was significantly lower than 36.67%in the control group(P<0.05),the blood drainage volume at 24 hours postoperation was(130.00±63.03)mL in the tranexamic acid group,which was significantly less than(264.33±141.23)in the control group(P<0.05).The levels of Hb and MCV in the tranexamic acid group were significantly higher than those of the control group on the 1st and 3rd day after surgery(P<0.05).There was a statistically significant difference in the amount of Hb loss on the first day after surgery between the two groups(P<0.05),while no significant difference was found in two groups in the amount of Hb loss on the third day after surgery(P>0.05).No postoperative complications such as deep vein thrombosis,pulmonary infection and incision infection occurred in the two groups.Conclusion Local application of tranexamic acid alone during THA in elderly patients with femoral neck fracture can significantly decrease the blood transfus
作者
杨乐
胡方勇
YANG Le;HU Fangyong(Armed Police Corps Hospital of Jiangsu Province,Yangzhou,Jiangsu,225003)
出处
《实用临床医药杂志》
CAS
2020年第20期29-32,36,共5页
Journal of Clinical Medicine in Practice
基金
江苏省扬州市科技计划项目(YZ2018086)。
关键词
股骨颈骨折
全髋关节置换术
氨甲环酸
输血率
引流量
femoral neck fracture
total hip arthroplasty
tranexamic acid
transfusion rate
volume of drainage
