静脉重复给药联合关节腔内注射氨甲环酸在初次髋关节置换中的应用  

Application of repeated intravenous medicine combined with intra-articular injection of tranexamic acid in primary hip replacement

作　　者：白伟侠 李昊儒 秦迪[3] 何丽英[3] 杨柳[3] 卢连君[4] 

机构地区：[1]河北医科大学第三医院关节一科,河北石家庄050051 [2]华北理工大学基础医学院,河北唐山063200 [3]河北医科大学第三医院骨病科,河北石家庄050051 [4]河北医科大学第三医院经济管理处,河北石家庄050051

出　　处：《河北医科大学学报》2017年第7期778-781,共4页Journal of Hebei Medical University

摘　　要：目的观察静脉重复给药联合关节腔内注射氨甲环酸在初次髋关节置换中的应用效果。方法选择初次髋关节置换术患者92例分为试验组和对照组各46例。试验组切皮前静脉滴注15mg/kg氨甲环酸,术中关节腔注射1.0g氨甲环酸,术后3h滴注10mg/kg氨甲环酸;对照组切皮前静脉滴注15mg/kg氨甲环酸,术中关节腔注射1.0g氨甲环酸。术后评估2组并发症、出血量、输血量、血红蛋白、血细胞比容、住院时间。结果术后3d 2组复查深静脉彩色超声均未发现深静脉血栓形成。2组各有1例输血,输血量均为400mL。试验组术后出血量少于对照组,术后血红蛋白含量高于对照组,差异有统计学意义(P<0.05);2组术中出血量、术后血细胞比容、住院时间差异无统计学意义(P>0.05)。结论静脉重复给药联合术中关节腔内注射氨甲环酸在初次髋关节置换术后出血量较术前静脉滴注联合术中关节腔内注射氨甲环酸出血量明显减少。Objective To evaluate the outcome of reduplicative intravenous administration combined with intra-articular injection of tranexamic acid（TXA） in primary total hip arthroplasty（THA）.Methods Total of 92 patients, accepting primary total hip arthroplasty, were divided into experiment group（intravenous administration of TXA 15 mg/kg before incision, intra-articular injection of TXA 1.0 g intra-operation, intravenous administration of TXA 10 mg/kg 3 hours post-operation, n=46） and, control group （intravenous administration of TXA 15 mg/kg before incision, intra-articular injection of TXA 1.0 g intra-operation, n=46）.Postoperative evaluation index include bleeding volume, transfusion volume and complications as well as variation of hemoglobin and blood volume, erythrocrit, and hospital stays.Results Three days after operation, no deep venous thrombosis（DVT） was found among all patients through ultrasounds.Both experiment group and control group have one patient receving transfusion with the volume of 400 mL.There was no significant difference between the two groups in intraoperative bleeding volume, haematocrit and hospital stay.However significant differences were found in postoperative bleeding volume and hemoglobin content between the two groups（P〈0.05）.Conclusion Postoperative bleeding volume was significantly decreased in primary THA with reduplicative intravenous administration combined with intra-articular injection of TXA.

关 键 词：关节成形术 置换 髋 氨甲环酸 出血 

分 类 号：R687.42[医药卫生—骨科学]