氨甲环酸关节腔内给药对单侧人工全膝关节置换术患者术后引流量的影响分析

目的 分析单侧人工全膝关节置换术患者给予氨甲环酸关节腔内给药对其术后引流量的影响。方法 将该院确诊并收治的94例膝关节骨性关节炎患者按照随机数字法分为对照组和研究组,每组47例。两组均实施单侧人工全膝关节置换术,对照组在关节囊缝合后单纯向囊内注射生理盐水混合液,研究组在关节囊缝合后向囊内注射氨甲环酸注射液与生理盐水混合液。术后常规实施抗血栓生成及康复锻炼,对失血量大的患者结合临床进行异体红细胞输注。对比两组术中出血量和术后引流量。对比两组术后24 h及72 h的血红蛋白(haemoglobin,Hb)、红细胞比容(hematocrit,Hct)、D-二聚体水平变化幅度。统计两组术后并发症及输血情况。结果 两组术中出血量差异无统计学意义(P＞0.05)。研究组术后24 h引流量及合计总引流量均显著低于对照组(P＜0.05)。两组术后24 h血红蛋白变化幅度,术后24 h及术后72 h D-二聚体变化幅度无显著差异(P＞0.05)。研究组术后72 h血红蛋白变化幅度、术后24 h及术后72 h红细胞比容变化幅度显著低于对照组(P＜0.05)。两组均无严重不良反应发生。两组输血率差异无统计学意义,但对照组中6例输血,研究组无输血病例。结论 单侧人工全膝关节置换术患者给予氨甲环酸关节腔内给药可显著减少术后引流量,遏制术后出血,从而避免引发贫血相关的并发症发生、避免输血治疗,有助于患者术后的恢复,同时不会增加下肢静脉血栓风险。

Analysis of impact of intra-articular administration of tranexamic acid on the postoperative drainage in patients treated with unilateral total knee replacement

ObjectiveTo analyze the impact of intra-articular administration of tranexamic acid on the postoperative drainage in patients treated with unilateral total knee replacement.Methods 94 cases of patients with knee osteoarthritis were randomly divided into the control group and the study group,with 47 persons in each group,all of whom were treated in our hospital from February 2013 to October 2015.Both groups were treated with unilateral total knee replacement,the control group simply received intracapsular injection of saline mixture after capsulorrhaphy, and the study group received intracapsular injection of ammonia tranexamic acid along with saline solution after capsulorrhaphy.After the operation,the patients underwent routine implementation of antithrombosis and rehabilitation exercise,and the patients experiencing a large blood loss also received allogeneic red blood cell transfusion.The bleeding volume and postoperative drainage volume in the two groups were compared.The amplitudes of level change of haemoglobin (HB),red blood cell hematocrit (HCT),and D-dimer in both groups at 24 h and 72 h after the operation were also compared.Results There was no significant difference between the two groups in blood loss during operation (P>0.05).The total flow rate 24 h after the operation and the total volume of the study group were significantly lower than the control group (P<0.05).There was no significant difference between the two groups in D-dimer levels at 24 h and 72 h after the operation (P>0.05).In the study group,the magnitude of changes in hemoglobin and hematocrit variation amplitudes were significantly lower than the control group (P<0.05).No serious adverse reactions occurred in both groups.There was no significant difference in blood transfusion rate between the two groups,but in the control group,6 people received blood transfusion.Conclusions Intraarticular administration of tranexamic acid in patients treated with unilateral artificial total knee replacement can significantly reduce the postoperative drainage,curb postoperative bleeding,thereby avoiding anemia related complications and transfusion therapy,helping patients with postoperative recovery,also not increasing the risk of venous thrombosis of lower extremity.