口服氨甲环酸在减少全膝关节置换术后出血的作用  

Oral tranexamic acid reduces blood loss in unilateral total knee arthroplasty

作　　者：刘江锋[1] LIU Jiangfeng(Department of Joint Surgery,Xingtai People′s Hospital,Xingtai,Hebei 054000,China)

机构地区：[1]河北省邢台市人民医院关节骨科,054000

出　　处：《检验医学与临床》2018年第17期2578-2581,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨口服氨甲环酸对全膝关节置换术后出血量的影响。方法收集该院2016年1月至2017年1月符合纳入标准的135例行初次单侧全膝关节置换术的患者进行前瞻性分析。将患者按随机数字表法分成3组,每组45例,第1组为口服氨甲环酸组(O组),第2组为静脉滴注氨甲环酸组(V组),第3组为未使用氨甲环酸组(C组)。记录3组患者术中、术后总失血量、显性和隐性失血量及输血量,观察患者有无下肢静脉血栓及皮肤损伤情况。结果 O组和V组,无论在总失血量、显性失血量还是隐性失血量,以及术后输血量等均少于C组,差异有统计学意义(P<0.05)。而O组和V组在总失血量、显性失血量、隐性失血量及输血量等方面比较,差异均无统计学意义(P>0.05)。3组患者手术切口均1期愈合,术后3个月超声检查未见肢体静脉血栓。结论全膝关节置换术前口服或静脉输注氨甲环酸均能减少术后出血量,降低输血率,降低患者围术期的贫血相关并发症,口服氨甲环酸更经济、安全,更值得临床提倡。Abstract：Objective To observe the efficacy and satety of tranexamic acid of in patients who receiving unilateral total knee arthroplasty （TKA）. Methods From January 2016 to January 2017,135 cases of patients who met the requirements and underwent primary unilateral TKA were prospectively analyzed.The patients were divided into three groups randomly（45 patients per group）.Group 1 was oral tranexamic acid group （group O）,group 2 was intravenous tranexamic acid group （group V）,and group 3 was untreated tranexamic acid group （group C）.Total intraoperative and postoperative blood loss,dominant and recessive blood loss and blood transfusion were recorded in the 3 groups.The venous thrombosis of lower extremity and skin condition were observed. Results Significant difference were found between group O and group C on total blood loss,drain volume,hidden blood loss and transfusion volume,similarly there were significent difference between group V and group C（ P 〈0.05）.However there were no difference between group O and group V on total blood loss,drain volume,hidden blood loss and transfusion volume.All the wounds healed primarily,there were not deep vein thrombosis and infections in any group.A total of 3 months postoperative ultrasonography showed no limb venous thrombosis. Conclusion Oral and intravenous application of tranexamic acid can significantly reduce postoperative blood loss and blood transfusion in TKA,oral tablets can be administrated more economically and safely,it should be advocated firstly.

关 键 词：关节置换 膝 氨甲环酸 

分 类 号：R684[医药卫生—骨科学]