不同剂量氨甲环酸对初次全髋关节置换失血量的影响  

Efficacy of different doses of tranexamic acid use for perioperative blood loss control in primary total hip arthroplasty

作　　者：施林军[1] 曹扬[1] 姜丹生[1] 

机构地区：[1]金华市中心医院骨科,浙江金华321000

出　　处：《临床骨科杂志》2015年第4期437-439,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨不同剂量氨甲环酸(TA)对初次全髋关节置换术(THA)围手术期失血量的影响。方法 160例行初次单侧THA的股骨颈骨折患者分为4组:TA 10 mg/kg组、TA 15 mg/kg组、TA 20 mg/kg组、对照组,每组各40例。手术开始前15 min,TA组将TA分别按10、15、20 mg/kg的剂量稀释于250 ml生理盐水后静滴;对照组予生理盐水250 ml静滴。比较各组围手术期总失血量、显性失血量、隐性失血量、异体输血量和静脉血栓发生率。结果 TA 10 mg/kg组、15 mg/kg组、20 mg/kg组围手术期总失血量、显性失血量、隐性失血量、异体输血量与对照组相比差异均有统计学意义(P<0.05);TA 15 mg/kg组、TA 20 mg/kg组与TA 10 mg/kg组相比,总失血量、隐性失血量和异体输血量差异均有统计学意义(P<0.05)。各组深静脉血栓(DVT)发生率比较差异均无统计学意义(P>0.05)。结论初次THA术前静脉使用TA能明显降低患者围手术期失血量和异体输血量,剂量15 mg/kg、20 mg/kg更为有效。Objective To investigate the efficacy of different doses of tranexamic acid （ TA ） use for perioperative blood loss control primary unilateral total hip arthroplasty（THA）. Methods 160 patients underwent primary THA due to femoral neck fracture were randomly divided into TA 10 mg/kg group, TA 15 mg/kg group, TA 20 mg/kg group and the control group with 40 cases in each group. In the TA group, 10 mg/kg,15 mg/kg or 20 mg/kg TA with 250ml normal saline was infused intravenously within 15 minutes before skin incision, while an equal volume of nor-mal saline was given instead in the control group. Total blood loss, visible blood loss, hidden blood loss, blood trans-fusion volume, blood transfusion rate, and the rate of deep vein thrombosis of different groups were compared. Re-sults In TA 10 mg/kg group, TA 15 mg/kg group or TA 20 mg/kg group, the total blood loss, visible blood loss, hidden blood loss and blood transfusion volume were all less than those in the control group. The difference had statis-tical significance（P〈0. 05）. Compared with TA 10 mg/kg group, the total blood loss, hidden blood loss and blood transfusion volume were significantly reduced in TA 15 mg/kg group or TA 20 mg/kg group（P〈0. 05）. While the incidence of deep venous thrombosis had no statistically significant differences among each group（P〉0. 05）. Con-clusions Intravenous infusion of TA within 15 minutes before skin incision reduces the perioperative blood loss and blood transfusion volume in primary unilateral THA significantly. Compared with 10 mg/kg, 15 mg/kg or 20 mg/kg TA gains more advantage of less perioperative blood loss.

关 键 词：全髋关节置换术 氨甲环酸 失血 

分 类 号：R687.4[医药卫生—骨科学] R973.1[医药卫生—外科学]