摘要
目的探讨术前应用氨甲环酸对老年股骨干骨折髓内钉固定术围术期隐性失血的影响。方法99例实施髓内钉固定术治疗的老年股骨干骨折患者,采用随机数字表法分为观察组(50例)和对照组(49例)。观察组术前应用氨甲环酸注射液进行治疗,对照组术前应用氯化钠注射液进行治疗。比较两组患者手术前后血红蛋白水平、失血量、输血及深静脉血栓发生情况。结果术后1、2、3 d,两组患者血红蛋白水平均明显低于本组术前,但观察组血红蛋白水平分别为(112.97±4.31)、(105.41±6.31)、(100.51±6.21)g/L,均高于对照组的(102.14±3.98)、(92.47±5.31)、(88.69±3.24)g/L,差异有统计学意义(P<0.05)。观察组总失血量为(689.57±9.34)ml、显性失血量为(113.45±5.14)ml、隐性失血量为(521.41±13.47)ml,均显著低于对照组的(967.41±13.57)、(157.34±5.15)、(801.36±15.41)ml,差异有统计学意义(P<0.05)。观察组围术期输血率28.00%(14/50)低于对照组的61.22%(30/49),差异具有统计学意义(P<0.05);观察组术后深静脉血栓发生率6.00%(3/50)略高于对照组的4.08%(2/49),但差异无统计学意义(P>0.05)。结论老年股骨干骨折患者髓内钉固定术术前静脉滴注氨甲环酸,能够有效缓解患者围术期隐性失血情况,减少输血率,且不会明显增加深静脉血栓发生率,具有临床推广价值。
Objective To discuss the effect of preoperative application of tranexamic acid on occult blood loss during perioperative period of intramedullary fixation of femoral shaft fracture in the elderly.Methods A total of 99 elderly patients with femoral shaft fractures and treated by intramedullary fixation were divided into observation group(50 cases)and control group(49 cases)according to the random numerical table.The observation group was treated with tranexamic acid injection before surgery,and the control group was treated with sodium chloride injection before surgery.The hemoglobin level before and after surgery,blood loss,blood transfusion and occurrence of deep vein thrombosis were compared between the two groups.Results At 1,2 and 3 d postoperatively,the hemoglobin levels in both groups were significantly lower than those preoperatively in this group;the hemoglobin levels in the observation group were(112.97±4.31),(105.41±6.31),and(100.51±6.21)g/L,which were higher than those of(102.14±3.98),(92.47±5.31),and(88.69±3.24)g/L in the control group;the differences were statistically significant(P<0.05).The observation group had total blood loss of(689.57±9.34)ml,dominant blood loss of(113.45±5.14)ml,and occult blood loss of(521.41±13.47)ml,which were significantly lower than those of(967.41±13.57),(157.34±5.15),and(801.36±15.41)ml in the control group,and the differences were statistically significant(P<0.05).The perioperative transfusion rate of 28.00%(14/50)in the observation group was lower than that of 61.22%(30/49)in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative deep vein thrombosis in the observation group was 6.00%(3/50),which was slightly higher than that of 4.08%(2/49)in the control group,but the difference was not statistically significant(P>0.05).Conclusion Intravenous infusion of tranexamic acid injection before intramedullary fixation in elderly patients with femoral shaft fracture can alleviate the occult blood loss during periop
作者
刘旭
曹阳
LIU Xu;CAO Yang(Department of Orthopeadic Surgery,First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China)
出处
《中国现代药物应用》
2023年第7期32-35,共4页
Chinese Journal of Modern Drug Application
关键词
老年股骨干骨折
氨甲环酸
隐性失血
髓内钉固定术
围术期
Femoral shaft fracture in the elderly
Tranexamic acid
Occult blood loss
Intramedullary fixation
Perioperative period
