氨甲环酸不同给药时间对全髋关节置换术中及术后失血量的影响

目的 探讨不同时间给予氨甲环酸静脉滴注对全髋关节置换术(total hip replacement,THA)术中及术后失血量的影响.方法 选取2012年2月至2014年2月我科收治的行单侧THA患者90例,按入院顺序随机分为三组,每组30例.对照组不给予氨甲环酸及同类药物;术前组于术前10 min及6h后分别给予1 g氨甲环酸静脉滴注;术中组于手术结束前10 min、术后6h分别给予1 g氨甲环酸静脉滴注.比较三组患者的术中失血量、术后失血量、术后绝对失血量、血红蛋白含量值变化、深静脉血栓形成(deep vein thrombosis,DVT)发生率.结果 三组患者术中、术后失血量和术后绝对失血量的差异有统计学意义(P＜0.05),术前组患者的上述指标均最低;三组患者血红蛋白减少值的差异有统计学意义(P＜0.05),术前组患者血红蛋白减少值最低;三组患者DVT发生率的差异无统计学意义(P＞0.05).结论 行THA患者于术前10 min及6h后分别静脉滴注氨甲环酸能很好地减少术中及术后失血量.

Effect of tranexamic acid at different administration time on the volume of blood loss in total hip replacement

Objective To assess the effect of tranexamic acid intravenous drip at different administration time on the intraoperative and postoperative blood loss in total hip replacement (THA). Methods Ninety cases of unilateral THA were selected from Department of Orthopaedics in our hospital from Feb. 2012 to Feb. 2014, and randomly divided into three groups according to the sequence number of admission, 30 cases in each group. Control group was not given tranexamic acid or similar drugs; Preoperative group was respectively given 1 g tranexamic acid at 10 min before operation and 6 h later. Intraoperative group was respectively given 1 g tranexamic acid 10 min before the end of operation and 6 h after operation. The intraoperative blood loss, postoperative blood loss, postoperative absolute blood loss, decrease of hemoglobin and the incidence of venous thrombosis were compared. Results There was significant difference in the intraoperative blood loss, postoperative blood loss, postoperative absolute blood loss and the decrease of hemoglobin among 3 groups (P<0.05), with the lowest in the preoperative group. The incidence of venous thrombosis showed no statistically significant difference among the three groups (P>0.05). Conclusion Administration of 1 g tranexamic acid at 10 min before operation and 6 h later to THA patients could reduce the volume of blood loss.