氨甲环酸关节腔内注射和自体血回吸收器对TKA术后失血的影响  

Comparison Research on the Blood Loss after Total Knee Arthroplasty between Tranexamic Acid Single Dose Intra-articular Injection of Tranexamic Acid and Autologous Blood Transfusion Drainage Systems

作　　者：王磊[1] 刘军[1] 史博 孙云波[1] 张宇[1] 赵慧雯[1] 孙振辉[1] 

机构地区：[1]天津市人民医院关节外科,300121 [2]甘肃省泾川县人民医院骨科

出　　处：《天津医药》2013年第8期779-781,共3页Tianjin Medical Journal

摘　　要：目的明确单剂量氨甲环酸(TXA)关节腔内注射和自体血回吸收器应用对全膝关节置换(TKA)术后失血的影响。方法回顾分析采用TKA治疗的内翻型膝关节骨性关节炎患者124例(124膝),男24例,女100例,平均年龄(65.03±6.84)岁。根据TKA控制术后失血的方法将所有患者分为TXA注射组(实验组,49例)和自体血回吸收器应用组(对照组,75例)。分析TKA术后血常规的变化、失血量和输血情况。结果术后7d实验组输血率为10.20%(5/49),对照组为17.33%(13/75),差异无统计学意义(P>0.05)。RBC、Hb、HCT在组间、时间和交互效应差异均有统计学意义(均P<0.01)。术后1、3、7d,实验组RBC、Hb、HCT均高于对照组(均P<0.05)。术后1、3d实验组总失血量小于对照组,术后7d,2组失血量比较差异无统计学意义(P>0.05)。结论关节腔内单剂TXA注射对于TKA术后止血安全有效。Objective To compare the efficiency of intra-artieular injection of tranexamic acid （TXA） and autolo- gous transfusion drain on the blood loss after total knee arthroplasty （TKA）. Methods A total of 124 patients （124 knees） with varus knee osteoarthritis, who were performed TKA, were retrospectively analyzed. Patients included 24 males and 100 females. The mean age was （65.03±6.84） years. Due to the blood loss control method, patients were divided into two groups including TXA application group （test group, n=49） and autologous transfusion drain group （control group, n=75）. The data of blood routine examination, blood loss and blood transfusion after TKA were analyzed. Results The blood transfusion rates were 10.20% （5/49） in test group and 17.33% （13/75） in control group 7 days after TKA surgery. There was no signifi- cant difference between two groups （P 〉 0.05）. There were significant differences in red blood cell （RBC）, hemoglobin （Hb） and haematocrit （HCT） between groups and effects of interaction in the two groups （P 〈 0.01）. Therewere significantly higher values of RBC, Hb and HCT at 1, 3 and 7 days after surgery in test group than those of control group （P 〈 0.05）.The total blood loss 1 and 3 days after TKA was significantly lower in test group than that of control group （P 〈 0.05）. There was no sig- nificant difference in the blood loss 7 days after surgery between two groups （P 〉 0.05）. Conclusion The single dose intra- articular injection of tranexamie acid is a safe and effective procedure for hemostasis after TKA.

关 键 词：膝关节 人工 关节成形术 置换 膝 氨甲环酸 输血 自体 失血 手术 

分 类 号：R684.3[医药卫生—骨科学]