氨甲环酸减少老年股骨头置换围手术期失血  

Efficacy and safety of tranexamic acid on perioperative blood loss in artificial femoral head replacement in the elderly

作　　者：李光磊[1] 王宝鹏[1] 张冰[1] 路世勇[1] 

机构地区：[1]滨州医学院附属临淄区人民院骨科,山东省临博市临淄区255400

出　　处：《中国矫形外科杂志》2015年第24期2230-2233,共4页Orthopedic Journal of China

摘　　要：[目的]探讨氨甲环酸对人工股骨头置换术围手术期失血量的影响及安全性。[方法]将60例人工股骨头置换术患者随机分为治疗组及对照组,每组30例。治疗组术前30 min静脉单次静滴氨甲环酸,对照组予以同等剂量的生理盐水。记录术中出血量、术后隐性出血量,彩超观察深静脉血栓形成情况。[结果]治疗组和对照组术中失血量分别为(304.7±19.9)ml和(348.5±14.8)ml,隐性失血量分别为(282.7±134.9)ml和(533.8±111.7)ml,组间比较差异有统计学意义(P<0.01)。治疗组术后有2例,对照组有10例需要输血,组间比较差异有统计学意义(P<0.05)。两组患者术后深静脉血栓发生率无明显差别。[结论]在人工股骨头置换术前使用组间比较氨甲环酸,可有效降低失血量及输血率,且不增加静脉血栓形成的风险。[ObjectiveJTo evaluate the efficacy and safety of using tranexamic acid to reduce the blood loss in gerontal patient who undergo artificial femoral head replacement during the perioperation period.[Method]Sixty patients who were scheduled to undergo artificial femoral head replacement were randomized divided into two groups：the treatment group（n = 30） and the control group（n = 30）,The treatment group was intravenously given tranexamic acid before the surgery,while the control group were given equivalent saline for instead.The blood loss during and after the operation were recorded,the blood routine examination was taken at the 24 h and the 72 h postoperatively.All the patients were examined for the color Doppler flow imaging of the lower limbs on the 7th and 14 th postoperatively days.All the data were analyzed with statistics software SPSS 17.0.[Result]The blood loss during the surgery in the treatment group and the control group were（304.7 ± 19.9） ml and（348.5 ± 14.8） ml,additionally,the hidden blood loss were（282.7 ± 134.9） ml and（533.8 ± 111.7） ml respectively.The differences between the two groups were statistically significant（P 0.01）.There were 2 patients in the treatment group and 10 patients in the control group reguiring blood transfusion postoperatively,with a significanctly statistical difference（P 0.05）,However,the prevalence of deep venous thrombosis in the two groups was no statistically different.[Conclusion]Using tranexamic acid before artificial femoral head replacement can significantly decrease blood loss and transfusion required without increasing risk for venous thrombosis.

关 键 词：氨甲环酸 人工股骨头置换术 失血 血栓 

分 类 号：R687.4[医药卫生—骨科学]