氨甲环酸在人工全髋关节置换术中局部应用的疗效分析  

Efficacy of topical tranexamic acid in total hip arthroplasty

作　　者：丁敏[1] 祁伟[2] 刘方刚[2] 徐正[2] 顾永福[2] 林木良[2] 

机构地区：[1]解放军第三五九医院医务处,镇江212001 [2]解放军第三五九医院骨科(全军肢体伤残治疗中心),镇江212001

出　　处：《医学研究生学报》2014年第8期833-835,共3页Journal of Medical Postgraduates

基　　金：南京军区医药卫生科研基金(ZD20)

摘　　要：目的人工全髋关节置换术（total hip arthroplasty,THA）是治疗股骨头无菌性坏死的重要方法。文中评价氨甲环酸在THA中局部关节腔内注射对于减少出血量及输血量的疗效。方法选取2011年7月至2013年7月解放军359医院收治的60例初次行单侧THA患者为研究对象,男性38例、女性22例,均为股骨头无菌性坏死,病程2~10年,平均6年,均采用后外侧入路。按照治疗方法分成试验组和对照组。试验组采取术中缝合切口后在关节腔内注射100mL氨甲环酸注射液处理;对照组患者不接受氨甲环酸注射。比较2组术中失血量、术后可见失血量、输血量、输血人数、术后血红蛋白等指标进行比较。结果 2组术中失血量比较差异无统计学意义[（200±60）mL vs（200±53）mL,P〉0.05],但试验组术后可见出血量少于对照组[（140±45）mL vs（362±53）mL,P〈0.05]、输血量少于对照组[（400±25）mL vs（750±50）mL,P〈0.05]、输血人数少于对照组（6 vs19,P〈0.05）;术后血红蛋白值则明显高于对照组[（95±15）g/L vs（81±12）g/L,P〈0.05]。结论在全髋关节置换术中局部应用氨甲环酸可明显降低患者失血量及输血量。Objective The article was to evaluate the efficacy of intra-articular tranexamic acid injection in reduction of blood loss and blood transfusion in total hip arthroplasty （THA）. Methods 60 patients hospitalized from July 2011 to July 2013 were selected as research subjects , among whom 38 males and 22 females with 2-10 years＇（ an average of 6 years） duration of femoral head aseptic necrosis were treated with initial unilateral THA using the posterolateral approach .The patients were randomly divided into 2 groups：experimental group were treated with 100 mL intra-articular tranexamic acid injection after intraoperative suture of incision , control group received no topical tranexamic acid .Intraoperative blood loss , postoperative visible blood loss , blood transfusion , blood transfusion number , postoperative hemoglobin were taken as evaluation indexes to make comparison between the two groups . Results No significant differences were found in intraoperative blood loss between the two groups （ [ 200 ±60 ] mL vs [ 200 ±53 ] mL, P 〉0.05）, but in comparison to control group, postoperation visible blood loss（[140 ±45]mL vs [362 ±53]mL, P〈0.05）, blood transfusion（[400 ±25]mL vs [750 ±50]mL, P〈0.05） and blood transfusion number in group A were significantly decreased （P〈0.05）, and in terms of postoperative hemoglobin value （[95 ±15]g/L vs [81 ±12]g/L, P〈0.05）, experimental group was signifi-cantly higher than control group（P〈0.05）. Conclusion Topical tranexamic acid in total hip arthroplasty can significantly lower blood loss and blood transfusion in patients .

关 键 词：氨甲环酸 全髋关节置换 血红蛋白 失血量 

分 类 号：R687.4[医药卫生—骨科学]