氨甲环酸在全膝关节置换中的应用及安全性 |
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作者姓名: | 林 业 张国梁 王跃文 |
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作者单位: | 内蒙古医科大学,内蒙古自治区呼和浩特市 010050;内蒙古医科大学附属医院骨科,内蒙古自治区呼和浩特市 010050 |
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基金项目: | 内蒙古自治区自然科学基金资助项目;内蒙古医科大学青年基金(qncx2013025):前交叉韧带重建术中胫骨侧止点无撞击区的影像学研究 |
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摘 要: |
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关 键 词: | 骨科植入物 人工假体 氨甲环酸 全膝关节置换 止血 剂量 显性失血 隐形失血 研究进展 内蒙古自治区自然科学基金 |
收稿时间: | 2015-12-07 |
Application and safety of tranexamic acid in total knee arthroplasty |
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Authors: | Lin Ye Zhang Guo-liang Wang Yue-wen |
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Institution: | Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China; Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China |
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Abstract: | BACKGROUND: Studies suggested that blood loss was great during total knee arthroplasty, even blood transfusion was needed. Application of the tourniquet will destroy the coagulation system, and is not conducive to hemostasis after replacement. Recently, tranexamic acid has been extensively used to reduce blood loss during total knee arthroplasty, because of low price, simple administration pathway, and effective effects on hemostasis.
OBJECTIVE: To summarize the application and safety of tranexamic acid in total knee arthroplasty.
METHODS: The first author retrieved PubMed and Chinese Journal Full Text Database for articles from inception to October 2015. The key words were tranexamic acid, total knee arthroplasty, hemorrhage. More than 200 articles were retrieved, and finally 50 articles met the inclusion criteria.
RESULTS AND CONCLUSION: Tranexamic acid is a fibrinolytic inhibitor, can reversibly block the binding of plasminogen to fibrin, effectively inhibit fibrinolysis, and reduce hemorrhage after total knee arthroplasty. Nevertheless, there were significant differences in the use, dose and effect of tranexamic acid on hemostasis among different studies. Tranexamic acid was an effective drug for hemostasis during total knee arthroplasty. During total knee arthroplasty, tranexamic acid had been used to reduce dominant blood loss and hidden blood loss after arthroplasty, and could not increase the risk for venous thrombosis of lower limb. Currently, the timing of use, dosage, route of administration, and possible complications of tranexamic acid remain controversial. |
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