氨甲环酸的不同给药途径对减少全膝关节置换术后失血量的研究  

The study of reducing postoperative blood loss of total knee arthroplasty by different dosage regimens of tranexamic acid

作　　者：安全明 缪莉莉[2] 蔺治凯[1] 陈德胜[1] 张佳林[1] 陈霄雷 

机构地区：[1]宁夏医科大学总医院脊柱骨科,宁夏银川750004 [2]宁夏医科大学总医院呼吸与危重医学科,宁夏银川750004

出　　处：《宁夏医学杂志》2017年第12期1103-1106,共4页Ningxia Medical Journal

摘　　要：目的探讨氨甲环酸的不同给药途径对减少人工全膝关节置换(TKA)术后失血量的效果研究。方法选择120例行单侧TKA的骨关节炎患者,分为A、B、C组3组,每组40例。A组向关节腔内注射氨甲环酸,剂量为20 mg/kg;B组静脉滴注氨甲环酸,剂量为20 mg/kg;C组静脉滴注联合关节腔内注射氨甲环酸,剂量均为10 mg/kg。比较3组患者术后的红细胞比容(Hct)及血红蛋白(Hb)值、术后24 h总引流量、下肢深静脉栓塞发生率及输血例数。结果 3组患者术后Hb、Hct,术后24 h引流量、总失血量比较,B组丢失量最为明显,差异有统计学意义(P<0.05)。进一步两两比较,在A、B组及B、C组分别比较,术后24 h的Hb及Hct值、72 h的Hb及Hct值、120 h的Hb及Hct值、术后24 h引流量、总失血量差异有统计学意义(P<0.05);A、B、C 3组两两比较隐形失血量差异无统计学意义(P>0.05);A、B、C组3组输血率分别为7.5%、12.5%、5%。结论初次行TKA的患者,采用静脉联合局部应用氨甲环酸可以明显减少TKA术后血液的丢失量。Objective To study the effect of different dosage regimens of tranexamic acid of reducing postoperative blood loss after TKA （total knee arthroplasty）. Methods 120 osteoarthriti patients who received unilateral TKA were divided into three groups： group A,group B and group C（n =40）. Group A was injected with tranexamic acid in the knee joint cavity at a dose of 20 mg / kg. Group B was given intravenous drip infusion of tranexamic acid at a dose of 20 mg / kg. Group C was given intravenous drip infusion combined with intracavitary injection of tranexamic acid ,The dose is both 10 mg / kg. Compared the hematocrit （Hct） and hemoglobin （Hb） values,the total drainage after 24 h, the incidence of deep vein thrombosis and the number of transfusion cases. Results Compared with the three groups, the loss of Hb, Hct, 24 h after operation and total blood loss were significantly higher in group B （ P 〈 0.05）. The Hb and Hct values,72 h Hb and Hct values,120 h Hb and Hct values, postoperative 24h drainage, total blood loss （P 〈 0.05）. There was no significant difference （P 〉 0.05 ） between A, B and C groups. The blood transfusion rates of group A, B and C were 7.5%, 12.5% and 5% respectively. Conclusions This study shows that the use of tranexamic acid in patients with TKA in the first place can significantly reduce the amount of blood loss during postoperative use.

关 键 词：氨甲环酸 全膝关节置换 给药途径 失血量 

分 类 号：R687.4[医药卫生—骨科学]