关节腔内灌注氨甲环酸联合定时加压冷疗对全髋关节置换术术后失血量的影响及安全性观察  

Observation of Tranexamic Acid Articular Injection Combined with Cold Therapy on Total Hip Arthroplasty

作　　者：杨玉霞[1] 聂惠莉 蔡鸿敏[1] 刘又文[1] 

机构地区：[1]河南省洛阳正骨医院河南省骨科医院,河南洛阳471002

出　　处：《中国中医骨伤科杂志》2016年第11期38-40,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:观察关节腔内灌注氨甲环酸联合定时加压冷疗对初次全髋关节置换失血量的影响及安全性。方法:48例股骨头坏死行单侧初次人工全髋关节置换的患者随机分成观察组和对照组。观察组术中切口缝合后将100mL,1.0g氨甲环酸注射液经引流管注入关节腔并立即夹闭引流管3h,术后24h内伤口局部加压冷疗;对照组仅局部加压冷疗。比较两组患者术后引流量,24,72h血红蛋白指数、输血量、输血人数、下床行走时间、术肢48h周径比及恢复生活自理时间。结果:通过对术后48h引流量、输血量、输血人数、24/72h血红蛋白指数、下床行走时间、术后48h术肢周径比及恢复生活自理时间的对比研究,观察组均优于对照组(P<0.05)。结论:关节腔内灌注氨甲环酸联合定时加压冷疗可明显降低初次人工全髋关节置换患者术后失血量,减少术肢肿胀、缩短因贫血导致的卧床时间,提高医护质量。Objectives：To observe the effect of tranexamic acid articular injection combined with cold therapy on total hip arthroplasty （THA） in order to facilitate the postoperative nursing. Methods： In a ninedmonth period of time from July 2014 to March 2015, 48 patients with femoral head necrosis who underwent primary THA were randomly grouped into the experimental group in which the tranexamic acid articular injection combined with cold therapy was administered postoperatively （n = 24）, and the control group in which the sole cold therapy was given （n=24）. For each patient of the experimental group, a dose of 100 mL： 1 g tranexamic acid was injected through the drainage tube into the hip joint immediately after the surgical wound closure. Then the drainage tube was closed lasting for three hours. For the first postoperative 24 h, a cold therapy on the site of the surgical wound （once every four hours, lasting for half an hour） was prescribed for all the patients of the two groups. Finally, observational parameters such as vol- ume of drainage, hemoglobin content at postoperative 24 h and 72 h, volume of blood transfusion, patient number of blood transfu- sion, circumference of the thigh on the wound side at 48h postoperatively, and the time starting to ambulate, were compared between the two groups. Results： The above mentioned parameters in the patients of the experimental group were superior to that of the pa- tients in the control group, and the differences were of statistical significance （P〈0.05）. Conclusion： Tranexamic acid injection com- bined with cold therapy can significantly reduce postoperative blood loss and volume of blood transfusion, lessen the swell, shorten the anemia deduced bed rest, lighten the nursing burden and improve the treating and nursing quality.

关 键 词：全髋关节置换 氨甲环酸 股骨头坏死 引流管 引流量 

分 类 号：R687.4[医药卫生—骨科学]