不放置引流管结合局部灌注TXA对全膝关节置换术后出血量的影响  

作　　者：鲍航行[1] 朱磊[2] 张佳颖 童培建[2] 

机构地区：[1]浙江省中医院,310006 [2]浙江中医药大学,310053

出　　处：《浙江临床医学》2018年第3期464-465,共2页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科研项目（2017KY513）;浙江省中医药科技计划青年人才基金项目（2017ZQ009）

摘　　要：目的探讨不放置引流管结合氨甲环酸（TXA）局部灌注对初次单侧全膝关节置换术（TKA）术后出血量的影响。方法回顾性分析112例膝关节骨关节炎（KOA）行TKA的临床资料，根据术中不同处理方式分为3组，观察组术中关闭筋膜层后局部灌注TXA（TXA2g＋生理盐水50ml）但不放置引流管；引流组关节腔放置引流管但不使用TXA；对照组不放置引流管且不使用TXA。观察三组血常规、输血情况及双下肢深静脉血栓发生情况。结果三组间术后总失血量、输血率、人均输血量比较，差异有统计学意义（P〈0.05）。观察组术后失血量最少，输血率最低，人均输血量最少，引流组最多；术后3组均未发现下肢深静脉栓塞情况。结论全膝关节置换术中不放置引流管结合局部灌注TXA能有效减少术后失血量，降低输血率，不增加下肢静脉血栓的风险。Objective To investigate the effect of the non-placement of drainage tube combined with the partial perfusion of tranexamic acid （ TXA ） on the blood loss after the first unilateral total knee arthroplasty （ TKA ） . Methods 112 cases underwent TKA because of knee osteoarthritis （ KOA ） were analyzed and divide into three groups according to different processing modes. The observation group was designed to dump TXA 2g and normal saline 50ml rather than drainage tube after closing fascia layer. The drainage group placed drainage tube in the joint cavity , without TXA. The control group had no intervention measures.The blood routine, blood transfusion and deep venous thrombosis were observed in three groups, respectively. Results The total postoperative blood loss, blood transfusion rate and per capita transfi^sion volume had statistically significant differences （P〈0.05） . The observation group had the least amount of blood loss, the lowest blood transfusion rate, the lowest per capita transfusion volume and the most drainage group. No postoperative deep vein thrombosis was found in all three groups. Conclusion Non-placement of drainage tube combined with the partial perfusion of TXA can effectively reduce blood loss and blood transfusion rate after TKA, without increasing the risk of deep vein thrombosis.

关 键 词：全膝关节置换 氨甲环酸 引流管 失血量 

分 类 号：R687.4[医药卫生—骨科学]