氨甲环酸对老年患者股骨转子间骨折手术后凝血及纤溶功能的影响

目的探讨氨甲环酸对老年患者股骨转子间骨折手术后凝血及纤溶功能的影响。方法123例老年股骨转子间骨折患者,随机分为对照组(60例)及观察组(63例)。对照组患者术后切口内注射氯化钠注射液,观察组患者术后切口处应用1%氨甲环酸注射液与0.9%氯化钠注射液。对比两组患者总失血量、隐性失血量及手术前后凝血功能及纤溶功能。结果观察组患者总失血量(575.24±112.74)ml、隐性失血量(467.73±103.44)ml均少于对照组的(985.52±163.48)、(724.89±134.55)ml,差异有统计学意义(P<0.05)。手术后,两组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、组织型纤溶酶原激活物(t-PA)水平比较差异无统计学意义(P>0.05);两组患者术后D-二聚体(D-D)水平高于手术前,但观察组D-D(302.13±43.14)g/L低于对照组的(582.61±50.23)g/L,差异有统计学意义(P<0.05)。结论局部应用氨甲环酸可减少老年股骨转子间骨折患者术后总失血量、隐性失血量,术后止血功能与抗纤维蛋白溶解效果优于对照组,值得临床应用。

Effect of tranexamic acid on coagulation and fibrinolytic function in elderly patients withintertrochanteric fracture

Objective To discuss the effect of tranexamic acid on coagulation and fibrinolytic function in elderly patients with intertrochanteric fracture.Methods A total of 124 elderly patients with intertrochanteric fracture were randomly divided into control group(60 cases)and observation group(63 cases).Patients in the control group received sodium chloride injection into the incision after operation,and patients in the observation group received 1%tranexamic acid injection and 0.9%sodium chloride injection at the incision after operation.The total blood loss,occult blood loss,coagulation function and fibrinolytic function before and after operation were compared between the two groups.Results The total blood loss(575.24±112.74)ml and occult blood loss(467.73±103.44)ml of the observation group were less than(985.52±163.48)and(724.89±134.55)ml of the control group,and the difference was statistically significant(P<0.05).After operation,there was no statistically significant difference in prothrombin time(PT),activated partial thromboplastin time(APTT),tissue-type plasminogen activator(t-PA)levels between the two groups(P>0.05).The D-Dimer after operation of the two groups was higher than that before operation,but the D-D(302.13±43.14)g/L of the observation group was lower than(582.61±50.23)g/L of the control group.All the difference was statistically significant(P<0.05).Conclusion Local application of tranexamic acid can reduce the total blood loss and occult blood loss in elderly patients with intertrochanteric fracture.The postoperative hemostatic function and anti fibrinolysis effect of are better than those of the control group,which is worthy of clinical application.