摘要
目的探究氨甲环酸(TXA)在髌上入路髓内钉治疗胫骨干骨折中的应用及有效性研究。方法本研究为回顾性队列研究,以2018年10月至2019年12月在空军军医大学第二附属医院因胫骨干骨折住院的90例患者为研究对象,根据术前是否使用TXA分为对照组和观察组:对照组术前不使用TXA,观察组术前使用TXA,两组均采用髌上入路胫骨髓内钉固定手术。记录两组的基本临床资料、计算失血量情况,并通过随访比较两组患者骨折愈合及并发症的情况。结果两组患者的年龄、体重指数、性别、骨折AO分型、ASA分级等基本临床资料比较,差异无统计学意义(P>0.05),具有可比性。两组患者的手术时长、平均住院时间等资料比较,差异无统计学意义(P>0.05)。与对照组相比,观察组的总失血量、显性失血量和隐性失血量均显著降低,同时术后VAS评分也显著降低,差异具有统计学意义(P<0.05)。两组患者术前Hb水平、术前Hct水平、术后72 h Hb水平、术后72 h Hct水平比较,差异均无统计学意义(P>0.05);观察组术后24 h Hb水平和Hct水平均显著高于对照组,差异具有统计学意义(P<0.05)。两组患者术后伤口情况、DVT和肺栓塞发生率比较无统计学差异(P>0.05)。随访发现,观察组膝关节功能评分显著高于对照组,差异均具有统计学意义(P<0.05)。结论髌上入路髓内钉固定治疗胫骨干骨折术前使用TXA,可以减少患者的隐性失血量,同时有效提高患者膝关节功能,且不会增加下肢深静脉血栓的发生风险,是一种相对安全有效的治疗方式,值得在临床上推广。
Objective To explore the application and effectiveness of tranexamic acid(TXA)in the treatment of tibial shaft fractures with suprapatellar intramedullary nails.Methods This study was a retrospective cohort study,taking 90 patients hospitalized with tibial shaft fractures in the Second Affiliated Hospital of Air Force Military Medical University from October 2018 to December 2019 as the research object.They were divided into control group and observation group according to whether TXA was used before operation:TXA was not used before operation in the control group while TXA was used before operation in the observation group,and both groups used suprapatellar approach tibial intramedullary nail fixation.Record the basic clinical data of the two groups,calculate the blood loss,and compare the fracture healing and complications of the two groups through follow-up.Results There was no significant difference in basic clinical data such as age,body mass index,gender,fracture AO classification,and ASA classification(P>0.05),and they were comparable.There was no significant difference in operation time and average length of stay(P>0.05),Compared with the control group,the total blood loss(TBL),visual blood loss(VBL)and hidden blood loss(HBL)of the observation group were significantly reduced,while the postoperative VAS score was also significantly reduced,and the differences were statistically significant(P<0.05).There was no significant difference between the two groups of patients in preoperative hemoglobin(Hb)and hematocrit(Hct)levels,and in postoperative 72 hours Hb and Hct levels(P>0.05);however,the postoperative 24 hours Hb and Hct levels in the observation group were significantly higher than those of the control group(P<0.05).There was no significant difference in the incidence of postoperative wounds,DVT and pulmonary embolism between the two groups(P>0.05).Follow-up found that the knee joint function score of the observation group was significantly higher than that of the control group(P<0.05).Conclusion The us
作者
祁鹏
王育才
曹卓
Qi Peng;Wang Yucai;Cao Zhuo(Department of Orthopedics,The Second Affiliated Hospital of Air Force Military Medical University,Xi'an Shaanxi,710038;Department of Orthopedics,The People's Hospital(The Fourth Hospital of Xi'an),Xi'an Shaanxi,710199,China)
出处
《生物骨科材料与临床研究》
CAS
2022年第1期49-53,共5页
Orthopaedic Biomechanics Materials and Clinical Study
基金
陕西省创新能力支撑计划(2021TD-45)。
关键词
氨甲环酸
髓内钉
胫骨干骨折
隐性出血
Tranexamic acid
Intramedullary nail
Tibial shaft fracture
Hidden blood loss
