不同时间点静脉滴注氨甲环酸对全髋关节置换术围术期出血及术后静脉血栓栓塞发生率的影响  

Effects of Intravenous Drip of Tranexamic Acid at Different Time Points on Incidence Rates of Perioperative Hemorrhage and Postoperative Venous Thromboembolism in Patients Undergoing Total Hip Arthroplasty

作　　者：杜燕 赵泽宇 唐涛 苟远涛 Du Yan;Zhao Zeyu;Tang Tao;Gou Yuantao(Sichuan Bayi Rehabilitation Center,Chengdu,Sichuan,China 611135)

机构地区：[1]四川省八一康复中心,四川成都611135

出　　处：《中国药业》2018年第21期46-48,共3页China Pharmaceuticals

基　　金：四川省卫生和计划生育委员会科研课题[16ZD042]

摘　　要：目的探讨不同时间静脉滴注氨甲环酸对全髋关节置换术(THA)围术期出血及术后静脉血栓栓塞(VTE)发生率的影响。方法选取行THA患者126例,按照随机数字表法分为观察组、对照1组及对照2组,各42例。对照1组于切皮前30 min静脉滴注氨甲环酸,对照2组于关闭切口前30 min静脉滴注氨甲环酸,观察组在上述2个时间点均静脉滴注氨甲环酸。结果术后1 d,3组患者D-二聚体(D-D)、纤维蛋白降解产物(FDP)、C反应蛋白(CRP)、白细胞介素6(IL-6)水平均较术前显著提升,且观察组明显低于对照组(P <0. 05); 3组患者手术时间比较无明显差异(P> 0. 05),而观察组术中失血量及术后3 d内失血量、引流量、血红蛋白降低最大差值、输血例数均明显少于对照组(P <0. 05);术后1周内,3组患者VTE、肺部感染及切口感染发生率均无明显差异(P> 0. 05)。结论 THA切皮前及关闭切口前均予以静脉滴注氨甲环酸可有效减少围术期出血,且不增加术后VTE发生率,有利于患者预后恢复。Objective To investigate the efrcts of intravenous drip in tranexamic acid at difrrent time points on the incidence rates of perioperative hemorrhage and postoperative venous thromboembolism（VTE） in patients undergoing total hip arthroplasty（THA）. Methods Totally 126 patients treated with THA were selected and divided into the observation group, control group i and control group 2 according to the random number table method, 42 cases in each group. The control group 1 was given intravenous drip of tranexamic acid at 30 rain before incision, the control group 2 was given intravenous drip of tranexamic acid at 30 rain before incision closure, and the observation group was given intravenous drip of tranexamic acid at the two time points. Results 1 d after operation, the levels of D-dimer（D-D）, fibrin degradation products（FDP）, C-reactive protein（CRP） and interleukin-6（IL-6） in the three groups were signifi- cantly higher than those before operation, and those in the observation group were significantly lower than those in the two control groups（P 〈 0. 05）. There was no significant difrrence in operative time among the 3 groups（P 〉 0.05）, while the intraoperative blood loss, blood loss within 3 d after operation, drainage volume within 3 d after operation, the maximum difrrence of hemoglobin decline within 3 d after operation, and the cases of blood transfusion within 3 d after operation in the observation group were significantly less than those in two control groups（P 〈 0. 05）. Within i week after operation, there was no statistical significance in the incidence rates of VTE, pulmonary infection and incision infection among the three groups（P 〉 0.05）. Conclusion Intravenous drip of tranexamic acid before incision and before incision closure in patients undergoing THA can efrctively reduce perioperative hemorrhage, and it will not increase the incidence rate of postoperative VTE, it is favorable for the prognosis and recovery of patients.

关 键 词：氨甲环酸 出血 静脉血栓栓塞 全髋关节置换术 

分 类 号：R969.4[医药卫生—药理学] R973.2[医药卫生—药学]