全膝关节置换关节内应用氨甲环酸的临床对比研究  

Clinical Studies on Intra-articular Injections of Tranexamic Acid after Total Knee Arthroplasty

作　　者：李阳[1] 张卫国[1] 李洪敬[1] 

机构地区：[1]大连医科大学附属第一医院骨外科,辽宁大连116011

出　　处：《医学与哲学（B）》2013年第9期27-30,共4页Medicine & Philosophy(B)

摘　　要：探讨氨甲环酸关节腔注射对全膝关节置换术后失血的影响。全膝关节置换患者30例随机分为两组,A组缝皮后关节腔注射氨甲环酸500mg/5ml,B组注射生理盐水5ml。观察术后失血量、输血率、疼痛视觉模拟评分(VAS)、皮下瘀斑、深静脉血栓形成、患膝周径变化率和术后6周膝关节功能HSS评分。A组总失血量、输血率、VAS评分、皮下瘀斑率和患膝周径变化率低于B组(P<0.05)。两组均无血栓形成,HSS评分无显著差异(P>0.05)。氨甲环酸关节内注射降低膝关节置换术后失血量、输血率、皮下瘀斑率,术后疼痛和关节肿胀及对功能和血栓形成无明显影响。To examine the influence of intra -- articular injections of tranexamic acid （TXA） on blood loss after total knee arthroplasty （TKA）. The study involved 30 TKA patients. All patients were randomized into group A and group B. Group A, patients were administered intra--artieular injections of 500mg/5ml TXA after closure. Group B, patients were administered intra- articular injections of 5ml physiological saline after closure. The total blood loss was compared between these＇two groups. Meanwhile, transfusion rate, visual analogue scale（VAS） pain score, ecehymosis rate, deep vein thrombosis （DVT） incidence, change rate of knee circumstance of operation leg and Hospital for Special Surgery （HSS） score 6 weeks after the operation was compared between these two groups. The total blood loss, transfusion rate, VAS, ecehymosis rate and change rate of knee circumstance of TXA group was lower than the control group. These differences were statistically significant（P〈0.05）. There was no significant difference between two groups with respect to HSS score （P〉0.05）. No DVT occurred in both the two groups. The results revealed intra--artieular injections of TXA decreased post--operative blood loss, transfusion rate, VAS, ecchymosis rate and joint swelling of TKA without influence of functional rehabilitation and DVT incidence.

关 键 词：全膝关节置换 氨甲环酸 术后出血 

分 类 号：R687.4[医药卫生—骨科学]