氨甲环酸对减少单髁置换术后出血量的效果评价  

Evaluation on the effect of Tranexamic Acid on decreasing bleeding volume after Unicompartment knee arthroplasty

作　　者：文涛[1] 薛华明[1] 马童[1] 涂意辉[1] Wen Tao Xue Huaming Ma Tong et al(Department of Orthopaedics, Yangpu Hospital Affiliated to Tongji University, Shanghai, 200090, Chin)

机构地区：[1]上海市同济大学附属杨浦医院,上海200090

出　　处：《生物骨科材料与临床研究》2016年第5期51-54,I0004,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的研究微创单髁置换术后经引流管局部注射氨甲环酸对单髁置换术后出血量的影响。方法前瞻性研究2013年1月～2013年7月采用MI—UKA治疗膝关节内侧间室骨性关节炎的患者100例，随机分为夹管4小时组（n=50）与氨甲环酸＋夹管4小时组（n=50）。分别比较两组患者术前、术后血红蛋白（Hb）浓度、红细胞压积（Hct）、术后48小时引流量、并发症与膝关节功能康复情况。结果两组间一般临床资料无统计学差异。术后经引流管局部注射氨甲环酸＋早期夹闭4小时组的总引流量显著低于仅早期夹管4小时组，而术后Hb、Hct值显著高于仅早期夹管4小时组，且有统计学意义（P〈0．05）。夹管4小时组在各时间点（术后24、36和48小时），其引流量明显多于局部注射氨甲环酸＋早期夹闭4小时组，有统计学差异（P〈0．05），且术后48小时Hb明显减少（P〈0．05），术后48小时Hct值有明显差异（P〈0．05）。经引流管局部注射氨甲环酸＋早期夹闭4小时组与早期夹管4小时组比较，术后2天和7天的VAS评分无统计学差异（P〉0．05）。术后2周，两组间VAS评分均无明显差异（P〉0．05）。术后相关并发症及膝关节功能评分等方面两组间无统计学差异（P〉0．05）。结论术后经引流管局部注射氨甲环酸能够显著减少MI—UKA术后的失血量，且不增加相关的术后并发症，功能恢复满意。Objective To explore the effect of joint injection of Tranexamic Acid through drainage tube on bleeding vol- ume after minimally invasive unicompartmental knee arthroplasty. Methods From Jan to Ju! 2013, 100 patients with medial compartment osteoarthritis of the knee joint were treated with minimally invasive UKA （MI-UKA）. They have been randomly divided into 2 groups ： Group with only pipe clip 4h （n=50） and Group with Tranexamic Acid ＋ pipe clip 4h （n=50）. This study is to compare the two groups on hemoglobin （HB） concentration before and after operation, on hematocrit （HCT）, on drainage volume during 48h, on postoperative complications and on rehabilitation of knee joint function. Results No statistical difference on general clinical data has been identified between the 2 groups. The total drainage volume of Group with Tranexamic Acid ＋ pipe clip 4h is significantly lower than the Group with only early pipe clip 4h, and the Group with Tranexamic Acid ＋ pipe clip 4h postoperative HB and HCT are significantly higher Group with only early pipe clip 4h （P〈0.05）. Group with only early pipe clip 4h drainage volume on different time points （post operation 24h, 36h and 48h） is significantly higher than Group with Tranexamic Acid ＋ pipe clip 4h （P〈0.05）, and its HB after 48h decreases significantly （P〈0.05）, HCT data after 48h also have clear difference （P〈0.05）. The pos- toperative VAS scores after 2d and 7d have no statistical difference （P〉0.05）. The postoperative VAS scores after 2w have no statistical difference neither （P〉0.05）. Postoperative complications and knee function evaluation has no statistical difference between 2 groups （P〉0.05）. Conclusion This study shows that postoperative joint injection of Tranexamic Acid through drainage tube can reduce dramatically bleeding volume after MI-UKA without increasing postoperative complications and blocking knee joint function recovery.

关 键 词：微创 单髁置换术 氨甲环酸 引流管夹管 出血量 

分 类 号：R687.4[医药卫生—骨科学]