欢迎访问药物流行病学杂志网站！

设为首页加入收藏

国家科技部中国科技论文统计源期刊

中国科技核心期刊

WHO西太平洋地区医学索引(WPRIM)收录期刊

湖北优秀期刊

《药物流行病学杂志》官方网站与投审稿系统变更通知<点击查看详情>

术后追加氨甲环酸对全膝关节置换术后失血影响的回顾性研究

Restropective Study of Effect of Postoperative Additional Tranexamic Acid on Blood Loss in Total Knee Arthroplasty

DOI：

中文关键词: 氨甲环酸追加全膝关节置换术失血

英文关键词:Tranexamic acid Additional venous injection Total knee arthroplasty Loss of blood

基金项目:廊坊市科学技术研究与发展计划（编号：2018013038）

作者	单位
刘震徐培杨进齐巍齐凡	霸州市第二医院骨外科河北霸州 065700

摘要点击次数: 1340

全文下载次数: 1745

中文摘要:

摘要目的：探讨术后静脉追加氨甲环酸对全膝关节置换术（TKA）后失血的影响。方法：回顾性分析 2015年3月～2018年 8月我院骨外科行初次单侧 TKA 150例患者的临床资料。根据氨甲环酸的应用方法将患者分为对照组(n＝89)和追加组(n＝61)。对照组于手术切皮前给予氨甲环酸20 mg·kg-1， ivd，3 h后再次给予氨甲环酸10 mg·kg-1， ivd；追加组于切皮前给予氨甲环酸20 mg·kg-1， ivd，3 h后和6 h后分别给予氨甲环酸10 mg·kg-1， ivd。比较两组总失血量、隐性失血量、术后Hb下降最大值、输血率、手术时间、住院时间、纤维蛋白降解产物（FDP）、D 二聚体（D D）、血栓形成情况、伤口并发症等指标差异。 结果：追加组总失血量、隐性失血量、术后Hb下降最大值均低于对照组（P＜0.05），但两组输血率、手术时间、住院时间的差异无统计学意义（P＞0.05）。两组术后均未发生症状性肺栓塞及下肢深静脉血栓等严重不良反应。两组术前、术后3 d的FDP、D D水平及术后3 d肌间静脉血栓发生率的差异无统计学意义（P＞0.05），追加组皮下瘀斑面积＞1% 发生率小于对照组 (P＜0.05)。结论：术后追加一个剂量的氨甲环酸可有效减少TKA 术后的失血量，且不会增加深静脉血栓的发生风险。

英文摘要:

ABSTRACT Objective: To investigate the effect of postoperative intravenous additional tranexamic acid (TXA) on blood loss in total knee arthroplasty (TKA). Methods: A restropective study was carried out in Second Hospital of Bazhou City. 150 patients undergoing primary unilateral TKA from department of bone surgery between March 2015 and August 2018 were divided into control group (n=89) and additional group (n=61). The patients in control group were received intravenous injection of 20 mg·kg-1 TKA before skin incision, and intravenous injection of 10mg·kg-1 TKA 3h later, additional group was received intravenous injection of 20 mg·kg-1 TKA before skin incision, and intravenous injection of 10 mg·kg-1 TKA 3h and 6h later. Total blood loss, recessive blood loss, maximum Hb decrease after surgery, blood transfusion rate, operation time, hospitalization time, fibrin degradation product (FDP), d dimer (D D), thrombosis, wound complications were observed and compared between the two groups.Results: The total blood loss, recessive blood loss, maximum Hb decreased after surgery in additional group were lower than those in control group, the differences were statistically significant (P<0.05). However, there were no statistically significant differences in blood transfusion rate, operation time and hospitalization time between the two groups (P>0.05). Symptomatic pulmonary embolism and deep venous thrombosis of lower extremity did not occur in both groups. There was no statistically significant difference in the level of FDP, d d and the incidence of 3d intramuscular vein thrombosis between the two groups (P>0.05), and the incidence of ecchymosis area >1% in additional group was lower than that in control group (P<0.05). Conclusion: One additional dose of TXA could effectively reduce blood loss after TKA without increasing the risk of deep vein thrombosis.

查看全文查看/发表评论下载PDF阅读器

关闭