局部注射氨甲环酸对首次行单侧全膝关节置换术后失血量的观察

目的总结局部注射氨甲环酸对于首次行单侧全膝关节置换术后失血情况的临床数据,探讨使用经验和效果。方法选取我院80例行单侧全膝关节置换术的患者作为研究对象,所有患者均因骨性关节炎入院,且均为首次手术。依据使用氨甲环酸与否将选择的患者分为观察组和常规组,观察组在关闭关节腔前在其关节囊内注射10 mL氨甲环酸,常规组注射10 mL生理盐水,两组均在注射后放置高负压引流瓶。对比两组术后血红蛋白(Hb)情况、引流量、输血情况以及出现下肢深静脉血栓并发症的情况。结果观察组术后24 h引流量以及失血情况显著低于常规组(P0.05);观察组术后红细胞比容(Hct)以及Hb指标高于对照组且两组差异有统计学意义(P0.05);观察组输血量和输血率等指标低于对照组(P0.05);两组术后出现下肢深静脉血栓的概率无统计学差异(P0.05)。结论针对全膝关节置换术患者在负压引流的基础上行氨甲环酸局部注射能够有效减少术后出血,降低患者输血需求,同时不会增加下肢深静脉血栓形成的风险。

Research of influence of local injection of tranexamic acid on unilateral total knee arthroplasty for the first time in patients with postoperative blood loss

［Abstract］ Objective To summarize the clinical data from local injection of tranexamic acid on unilateral total knee arthroplasty forthe first time in patients with postoperative blood loss. Methods Eighty cases of patients who underwent the unilateral total knee arthroplasty in our hospital were selected as the research objects，and all patients were admitted to the hospital for osteoarthritis，and all were performed the operation for the first time. The patients were divided into the observation group and the control group according to the principle of randomized control. The observation group were injected the 10 ml tranexamic acid in the capsule of the joint before closing the joint cavity ，while the control group were injected with 10 ml normal saline. Then，two groups were placed the high negative pressure drainage bottle after the injection，and the hemoglobin，flow rate，blood transfusion，and complications of deep venous thrombosis of the lower extremities after operation of two groups were compared. Results The flow rate and the condition of blood loss after operation for 24 h in the observation group was significantly lower than that in the control group （P<0.05）. The erythrocyte specific volume and hemoglobin index after operation in the observation group were higher than those in the control group ， and the difference between the two groups was statistically significant（P<0.05）. The blood transfusion rate and blood transfusion rate in the observation group were lower than that in the control group （P< 0.05）. There was no statistical difference in the probability of deep venous thrombosis after the operation between the two groups（P>0.05）. Conclusion The tranexamic acid injection on the basis of negative pressure drainage treatment for patients with total knee arthroplasty which can effectively reduce postoperative bleeding and reduce the demand for blood transfusion. At the same time，it does not promote the risk of deep venous thrombosis of the lower extremity，thus it is worth further promoting and applying in clinical practice.