氨甲环酸在髌上入路髓内钉治疗胫骨干骨折中的应用研究

目的 探究氨甲环酸(TXA)在髌上入路髓内钉治疗胫骨干骨折中的应用及有效性研究.方法 本研究为回顾性队列研究,以2018年10月至2019年12月在空军军医大学第二附属医院因胫骨干骨折住院的90例患者为研究对象,根据术前是否使用TXA分为对照组和观察组:对照组术前不使用TXA,观察组术前使用TXA,两组均采用髌上入路胫...

Application of tranexamic acid in the treatment of tibial shaft fractures with suprapatellar intramedullary nails

Objective To explore the application and effectiveness of tranexamic acid (TXA) in the treatment of tibial shaft fractures with suprapatellar intramedullary nails. Methods This study was a retrospective cohort study, taking 90 patients hospitalized with tibial shaft fractures in the Second Affiliated Hospital of Air Force Military Medical University from October 2018 to December 2019 as the research object. They were divided into control group and observation group according to whether TXA was used before operation: TXA was not used before operation in the control group while TXA was used before operation in the observation group, and both groups used suprapatellar approach tibial intramedullary nail fixation. Record the basic clinical data of the two groups, calculate the blood loss, and compare the fracture healing and complications of the two groups through follow-up. Results There was no significant difference in basic clinical data such as age, body mass index, gender, fracture AO classification, and ASA classification (P>0.05), and they were comparable. There was no significant difference in operation time and average length of stay(P>0.05), Compared with the control group, the total blood loss (TBL), visual blood loss (VBL) and hidden blood loss (HBL) of the observation group were significantly reduced, while the postoperative VAS score was also significantly reduced,and the differences were statistically significant (P<0.05). There was no significant difference between the two groups of patients in preoperative hemoglobin (Hb) and hematocrit (Hct) levels, and in postoperative 72 hours Hb and Hct levels (P>0.05); however, the postoperative 24 hours Hb and Hct levels in the observation group were significantly higher than those of the control group (P<0.05). There was no significant difference in the incidence of postoperative wounds, DVT and pulmonary embolism between the two groups (P>0.05). Follow-up found that the knee joint function score of the observation group was significantly higher than that of the control group (P<0.05). Conclusion The use of TXA before the treatment of tibial shaft fractures with suprapatellar intramedullary nails fixation can reduce the patient''s hidden blood loss, which can effectively improve the knee function of patients without increasing the risk of deep vein thrombosis in lower extremities. It is a relatively safe and effective treatment method and worthy of clinical promotion.