微创膝关节单髁置换术后关节腔内注射氨甲环酸止血效果分析

目的：探讨关节腔内注射氨甲环酸对微创膝关节单髁置换术后出血量和输血率的影响。方法：自2015年1月至2017年9月收治90例行微创膝关节单髁置换术患者，分为氨甲环酸组和对照组，每组45例。氨甲环酸组男22例，女23例，年龄62~69（66.1±2.4）岁；对照组男20例，女25例，年龄63~71（68.5±5.2）岁。记录术后48 h引流球中的出血量、围手术期输血率和血细胞比容水平。影响围手术期出血量的因素包括性别、年龄和体重指数（body mass index，BMI）。结果：所有患者获得随访，时间12.5~28.3（22.8±7.9）个月。随访中，两组患者伤口均愈合良好，均未发生深静脉血栓形成和肺栓塞。氨甲环酸组患者术后出血量与对照组比较差异无统计学意义，氨甲环酸组术后引流球中出血量为（110.0±52.1）ml，对照组为（123.0±64.5）ml，两组差异无统计学意义（P=0.39）。两组患者围手术期都未输血。。结论：关节腔内注射氨甲环酸不能显著减少微创单髁置换患者术后的出血量。

Analysis of hemostatic effect of intra-articular injection of tranexamic acid after minimally invasive unicompartmental knee arthroplasty

Objective: To investigate the effect of intra-articular injection of tranexamic acid on blood loss and blood transfusion rate after minimally invasive unicompartmental knee arthroplasty. Methods: From January 2015 to September 2017,90 patients underwent minimally invasive unicompartmental knee arthroplasty were divided into tranexamic acid group and control group,45 cases in each group. In the tranexamic acid group,there were 22 males and 23 females,aged 62 to 69 (66.1±2.4) years;in the control group,20 males and 25 females,aged 63 to 71(68.5±5.2) years. The amount of bleeding in the drainage ball at 48 hours after operation was recorded,and the blood transfusion rate and hematocrit level during the perioperative period were recorded. The factors influencing perioperative blood loss included gender,age and body mass index(BMI). Results: All patients were followed up for 12.5 to 28.3 (22.8±7.9) months. During the follow-up,the wounds of the two groups healed well,and no deep vein thrombosis and pulmonary embolism occurred. There was no significant difference in postoperative blood loss between the tranexamic acid group and the control group. The postoperative bleeding volume in the tranexamic acid group was (110.0±52.1) ml,and that in the control group was (123.0±64.5) ml (P=0.39). There was no blood transfusion in the two groups. Conclusion: Intra articular injection of tranexamic acid can not significantly reduce the postoperative blood loss in patients with minimally invasive unicompartment.