中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (10): 887–890.doi: 10.12007/j.issn.0258-4646.2016.10.005

• 论著 • 上一篇    下一篇

全髋关节置换术中使用氨甲环酸的有效性及安全性研究

张杭州,白希壮,梁庆威,雷则鸣   

  1. 中国医科大学附属第一医院运动医学科与关节外科,骨科,沈阳 110001
  • 收稿日期:2016-01-24 出版日期:2016-10-30 发布日期:2016-10-11
  • 作者简介:张杭州(1984 -),男,主治医师,博士 .
  • 基金资助:
    国家自然科学基金(81501857)

Efficiency and Safety of Tranexamic Acid Intravenous Infution in Perioperative Total Hip Arthroplasty

ZHANG Hangzhou,BAI Xizhuang,LIANG Qingwei,LEI Zeming   

  1. Department of Sports Medicine and Joint Surgery/Orthopaedics,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2016-01-24 Online:2016-10-30 Published:2016-10-11

摘要: 目的 探讨在全髋关节置换术中静脉使用氨甲环酸的有效性及安全性。方法 选择 2014 年 6 月至 2015 年 6 月于我科行初次单侧全髋关节置换的患者 120 例,分为氨甲环酸组(关闭切口前给予氨甲环酸 10 mg/kg)和对照组(不给予氨甲环酸),每组 60 例。 比较 2 组患者术后引流量、术后血红蛋白水平、输血比例及输血量、深静脉血栓发生率。结果 氨甲环酸组术后引流量[(237.53±45.19)mL]低于对照组[(401.37±73.72)mL],氨甲环酸组术后血红蛋白水平[(127.57±13.55)g/L]高于对照组[(111.4±14.32)g/L],对照组术后输血率[37%(22/60)]高于氨甲环酸组[8%(5/60)],差异均有统计学意义。2 组患者在术后 3个月内均未发生肺栓塞,2 组深静脉血栓发生率无明显差异(1.67 % vs 3.33%)。结论 全髋关节置换术中使用氨甲环酸能够有效减少术后失血量,降低术后输血比例。

关键词: 全髋关节置换术, 氨甲环酸, 失血量

Abstract: Objective To explore the efficiency and safety of intravenous infution of tranexamic acid(TXA)in total hip arthroplasty(THA). Methods From June 2014 to June 2015,120 patients receiving unilateral THA were randomly divided into 2 groups,60 patients in each group. Patients in the control group didn’t receive TXA;in the experimental group,the patients received 10 mg/kg TXA by intravenous infusion. The volume of postoperative blood drainage,hemoglobin,proportion of patients received blood transfusion,volume of blood transfusion,and the incidence of the deep vein thrombosis(DVT)were compared between the two groups. Results In the control group,the postoperative drainage volume was401.37±73.72 mL;while in the experimental group,the postoperative drainage volume was 237.53±45.19 mL. No significant difference were found between the two groups in postoperative drainage volume(P > 0.05). In the control group,the postoperative hemoglobin level was 111.4±14.32 g/L; while in the experimental group,the postoperative hemoglobin level was 127.57±13.55 g/L. There was significant difference between the two groups(P < 0.05). In the control group,the postoperative ratio of transfusion(37%)was higher than that of the experimental group(8%)(P < 0.05). No significant difference was found between the two groups in postoperative DVT(1.67% vs 3.33%,P > 0.05). There was no pulmonary embolism in both of the 2 groups 3 months postoperatively. Conclusion TXA intravenous infusion can significantly decrease the postoperative blood loss and ratio of blood transfusion.

Key words: toatal hip arthroplasty, tranexamic acid, blood loss

中图分类号: 

  • R687.4
[1] 王立国,李旭,李雷明,孟凡贺,王军,边磊,杜张诊,范广宇. 软组织修复预防后路初次全髋关节置换术后脱位的Meta分析[J]. 中国医科大学学报, 2014, 43(9): 842-845.
[2] 顾世忠,梁庆威,李良满,周志成,刘晓峰. 全髋关节置换术治疗老年髋关节骨性关节炎合并股骨转子间骨折的临床疗效分析[J]. 中国医科大学学报, 2014, 43(4): 361-362.
[3] 杨礼庆, 付勤, 李希. Pinnacle髋臼杯系统在年轻患者髋关节置换术中的应用[J]. 中国医科大学学报, 2012, 41(2): 178-179.
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