低剂量氨甲环酸在全髋关节置换术中的应用  

Role of low dose tranexamic acid in total hip replacement

作　　者：孙晓琳[1] 马春娅[1] 关晓珍[1] 于洋[1] 汪德清[1] SUN Xiaolin MA Chunya GUAN Xiaozhen YU Yang WANG Deqing(Department of Blood Transfusion, Center for Clinical Transfusion Medicine, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院输血科,全军临床输血中心,北京100853

出　　处：《解放军医学院学报》2016年第11期1129-1131,共3页Academic Journal of Chinese PLA Medical School

基　　金：部委级资助项目;全军后勤科研重点项目(BWS16J006)~~

摘　　要：目的探讨单髋关节置换手术中低剂量应用氨甲环酸(tranexamic acid,TXA)在减少异体红细胞输注方面的作用。方法选取2013年1月-2015年6月在我院进行单髋关节置换术的病人181例,按照术中是否使用氨甲环酸分为氨甲环酸组(TXA组)88例和对照组(Control组)93例,比较两组病人手术后血红蛋白值、术中血红蛋白下降程度、异体红细胞平均输注量、术中失血量、术后引流量等指标。结果两组病人术前血红蛋白(P=0.850)、术中失血量(P=0.072)、术后引流量(P=0.214)、异体红细胞平均输注量(P=0.091)等指标的差异无统计学意义,术后血红蛋白TXA组为(125.65±39.02)g/L、对照组为(112.08±15.44)g/L;术中血红蛋白下降程度TXA组为(3.55±35.41)g/L、对照组为(16.59±14.19)g/L;以上指标两组间差异均有统计学意义。结论低剂量使用氨甲环酸可以减少手术中血红蛋白的下降值,但并不能减少异体红细胞平均输注量。Objective To evaluate the role of low dose tranexamic acid in reducing allogenic blood transfusion in total hip replacement surgery. Methods One hundred and eighty-one patients who underwent total hip replacement from January 2013 to June 2015 in our hospital were enrolled in this study, and they were divided into TXA group（n=88） and control group（n=93） according to the usage of TXA. The indexes, including pre-or postoperative Hb, fall in Hb, mean unit of allogeneic red blood cells transfusion, intraoperative blood loss, postoperative drainage, were compared between two groups. Results There were no significant differences in preoperative Hb（P=0.850）, intraoperative blood loss（P=0.072）, postoperative drainage（P=0.214）, and mean unit of allogeneic red blood cells transfusion（P=0.091） between two groups. While, there were significant differences in postoperative Hb [TXA group：（125.65±39.02） g/L vs control group：（112.08±15.44） g/L], and fall in Hb [TXA group：（3.55±35.41） g/L vs control group：（16.59±14.19） g/L]. Conclusion Using of low dose tranexamic acid is effective in reducing the fall of postoperative Hb, while it cannot reduce the requirement of allogenic blood transfusion in total hip replacement surgery.

关 键 词：全髋关节置换术 全髋关节成形术 氨甲环酸 红细胞输注 

分 类 号：R687.4[医药卫生—骨科学]