术前单一剂量氨甲环酸对初次全髋关节置换术围手术期失血的影响及安全性评估  

Efficacy and safety of single preoperative dose tranexamic acid use for perioperative blood loss controi in patients having primary total hip arthroplasty

作　　者：张弛[1] 乔志[1] 刘宏建[1] 殷力[1] 张宜远[2] 王义生[1] 

机构地区：[1]郑州大学第一附属医院骨科,450052 [2]解放军总医院骨科

出　　处：《中华实验外科杂志》2014年第4期900-902,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨使用氨甲环酸是否能够安全、有效地减少全髋关节置换术围手术期的出血量和输血率。方法将100例行全髋关节置换术患者随机平均分为两组，氨甲环酸组于切皮前15min将氨甲环酸按20mg/kg单一剂量静脉输注，对照组同时间点给予等量生理盐水。对比术后2d的血红蛋白减少量、输血量、输血人数和术后静脉血栓形成风险的差异。结果氨甲环酸组患者血红蛋白减少量、输血量和输血人数分别为（44．3±13．2）g/L、（338．8±92．7）ml、13例（26％），低于对照组的（53．4±8．9）g/L、（459．7±188．5）ml、29例（58％，P〈0．05）；两组患者术后深静脉血栓发生率差异无统计学意义（P〉0．05）。结论氨甲环酸能够减少全髋关节置换术患者围手术期的出血量和输血率，不增加术后血栓形成的风险。Objective To investigate the efficacy and safety of single preoperative dose tranexamic acid use for perioperative blood loss control in patients having primary total hip arthroplasty. Methods One hundred patients having primary total hip arthroplasty were randomly divided into 2 groups, the tranex amic acid group and the control group, with 50 patients in each. In the tranexamic acid group, a single dose of 20 mg/kg was infused intravenously within 15 minutes before skin incision, while an equal volume of normal saline was given instead in the control group. Hemoglobin losses, blood transfusion volume and blood transfusion rate of these two groups were measured before and two days after operation, the compara tive analysis was conducted. Deep vein thrombosis was also observed in these two groups. Results Hemo globin losses, blood transfusion volume and blood transfusion rate in the tranexamie acid group were （44. 3 ± 13.2） g/L, （338.8 ±92.7） ml, 13 （26%）, lower than the control group （53.4 ±8.9） g/L, （459. 7 ± 188.5） ml, 29 （58%） （P 〈 0. 05 ）; while no significant difference was detected in the inci dence of venous thrombosis （P 〉 0. 05 ）. Conclusion Tranexamic acid use preoperatively can reduce perioperative blood loss without inereasing risk for venous thrombosis.

关 键 词：氨甲环酸 全髋关节置换术 失血 静脉血栓形成 

分 类 号：R687.4[医药卫生—骨科学]