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局部应用氨甲环酸对全髋关节置换术失血量及安全性疗效研究
引用本文:王建,李业海,徐俊杰.局部应用氨甲环酸对全髋关节置换术失血量及安全性疗效研究[J].重庆医学,2017,46(15).
作者姓名:王建  李业海  徐俊杰
作者单位:安徽医科大学附属巢湖医院骨二科,安徽巢湖,238000
摘    要:目的 研究局部应用氨甲环酸(TXA)对减少全髋关节置换术(THA)失血量及安全性疗效.方法 选取2014年11月至2016年3月该院骨科收治的63例初次行单侧THA患者为研究对象,随机分为2组,A组37例,B组26例.A组于手术缝皮结束后关节腔引流管内注入2.0 g TXA(溶于10 mL生理盐水).B组于手术缝皮结束后关节腔引流管内注入同等量的生理盐水.比较两组患者置换前和置换后24、48、72 h血红蛋白、红细胞压积,术后失血量,输血量,输血人数,以及置换前和置换后24、48、72 h纤维蛋白原、凝血酶原时间及活化部分凝血活酶时间、下肢深静脉彩超.结果 A组患者置换后24、48、72 h血红蛋白、红细胞压积、术后失血量、输血量、输血人数均明显优于B组,比较差异有统计学意义(P<0.05).而两组置换前和置换后24、48、72 h纤维蛋白原、凝血酶原时间及活化部分凝血活酶时间、下肢深静脉彩超比较差异无统计学意义(P>0.05).结论 局部应用TXA可以明显减少THA围术期的失血量且不增加下肢深静脉血栓形成风险.

关 键 词:氨甲环酸  关节成形术  置换    出血  全髋关节置换  失血量  安全性

Effect of topical application of tranexamic acid on blood loss and safety of total hip arthroplasty
Wang Jian,Li Yehai,Xu Junjie.Effect of topical application of tranexamic acid on blood loss and safety of total hip arthroplasty[J].Chongqing Medical Journal,2017,46(15).
Authors:Wang Jian  Li Yehai  Xu Junjie
Abstract:Objective To study the effect of topical application of tranexamic acid(TXA)in total hip arthroplasty(THA).Methods A total of 63 patients with unilateral THA were enrolled in this study from November 2014 to March 2016.All patients were randomly divided into group A(n=37)and group B(n=26).Group A was injected with 2.0 g TXA(dissolved in 10 mL saline)in the joint cavity tube after the end of the surgical dressing.Group B injected the same amount of saline.The hemoglobin,hematocrit,postoperative blood loss,blood transfusion,blood transfusion and replacement of 24,48,72 h after the replacement,24,48 and 72 h after fibrinogen,prothrombin time and activation of part of the thromboplastin time,lower extremity deep vein ultrasound between the two groups were compared.Results The hemoglobin,hematocrit,postoperative blood loss,blood transfusion and blood transfusion were significantly better in group A than those in group B at 24,48 and 72 h after replacement(P<0.05).There was no significant difference in fibrinogen,prothrombin time and activated partial thromboplastin time between the two groups before and after replacement for 24,48,72 h(P>0.05).Conclusion The local application of TXA group can significantly reduce the THA perioperative blood loss without the increase of the risk of deep vein thrombosis.
Keywords:tranexamic acid  arthroplasty  replacement  hip  hemorrhage  total hip replacement  blood loss  security
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