不同方式使用氨甲环酸对全膝关节置换术后出血的影响及其安全性

目的探讨不同方式使用氨甲环酸对全膝关节置换术(TKA)患者术后出血的影响及其安全性。方法将154例行初次单侧TKA的患者分为3组:术中局部和静脉联合使用氨甲环酸组(A组,52例),局部使用氨甲环酸组(B组,53例),未使用氨甲环酸组(C组,49例)。比较3组患者术后引流量、输血率、输血量、术后第1、3天血红蛋白值、D-二聚体值及术后下肢深静脉血栓和肺栓塞的发生率。结果术后引流量、输血率、输血量A组低于B、C组(P0.05),B组低于C组(P0.05)。术后第1、3天血红蛋白值A组高于B、C组(P0.05),B组高于C组(P0.05)。术后第1、3天D-二聚体值及下肢深静脉血栓和肺栓塞发生3组比较差异无统计学意义(P0.05)。结论在TKA中联合使用和局部使用氨甲环酸可减少术后出血,联合使用效果更好,且不增加下肢静脉血栓及肺栓塞风险。

The impact and safety analysis in different using mode of tranexamic acid of blood loss after ;total knee arthroplasty

Objective To investigate the impact and safety analysis of different using mode of tranexamic acid in blood loss after total knee arthroplasty( TKA) . Methods To analysis total data of 154 cases who received TKA. Lo-cal application with intravenous infusion of 52 cases were divided into group A, local application of 53 cases into group B, and 49 cases who didn′t use of tranexamic acid into group C. The postoperative wound drainage volume, blood transfusion rate, blood transfusion volume, the hemoglobin level and D-Dimer measured on the first and third day, deep vein thrombosis,pulmonary embolism were compared among the three groups. Results The postoperative wound drainage and blood transfusion volume were lower in group A compared with group B and C(P<0. 05), group B was lower than group C(P<0. 05). The hemoglobin level measured on the first and third day were higher in group A compared with group B and C(P<0. 05), group B was higher than group C(P<0. 05). The D-Dimer measured on first and third day, deep vein thrombosis,pulmonary embolism was not significant among the three groups( P>0. 05 ) . Conclusions Local application with intravenous infusion and local application of tranexamic acid can reduce the blood loss in TKA with no increase of deep vein thrombosis and pulmonary embolism.