局部联合应用氨甲环酸对全髋关节置换失血量的影响  

Effect of topical combined with tranexamic acid on blood loss in total hip arthroplasty

作　　者：郝申申 姬小娜[1] 刘志斌[1] 刘荣荣[1] 奥乐 王艳玲[1] 王延峰[2] 范亚杰[1] HAO Shen-shen;JI Xiao-na;LIU Zhi-bin;LIU Rong-rong;AO Le;WANG Yan-ling;WANG Yan-feng;FAN Ya-jie(Dept of Orthopaedics,the Affiliated Hospital of Yan′an University,Yan′an,Shaanxi716000,China)

机构地区：[1]延安大学附属医院骨科,陕西延安716000 [2]延安大学附属医院检验科,陕西延安716000

出　　处：《临床骨科杂志》2018年第2期182-184,共3页Journal of Clinical Orthopaedics

基　　金：陕西省社会发展科技攻关项目(编号:2015SF115);延安市科技惠民计划项目(编号:2016HM-10-03)

摘　　要：目的观察局部联合应用氨甲环酸(TXA)对全髋关节置换(THA)围手术期失血量的影响。方法将90例初行单侧THA患者随机分为A组(术中20 ml含1.0 g TXA生理盐水,分2次浸润+术后灌注50 ml含1.0 g TXA生理盐水)、B组(术中20 ml含1.0 g TXA生理盐水,分2次浸润+术后灌注50 ml生理盐水)、C组(术中20 ml生理盐水,分2次浸润+术后灌注50 ml含1.0 g TXA生理盐水)各30例,分别在术中局部浸润和术后经引流管逆行灌注。比较3组术中失血量、术后引流量、术后第3天血红蛋白(Hb)以及发生深静脉血栓(DVT)例数。结果术中失血量:A组与B组比较差异无统计学意义(P>0.05),A、B组均少于C组(P<0.05)。术后引流量:A组与C组比较差异无统计学意义(P>0.05),A、C组均少于B组(P<0.05)。术后第3天Hb:A组高于B、C组(P<0.05),B组与C组比较差异无统计学意义(P>0.05)。3组均无DVT发生。结论局部应用TXA可减少初次行单侧THA的失血量,术中局部浸润可减少术中失血量,术后灌注可减少术后引流量,联合应用效果更佳。Objective To investigate effect of topical combined with tranexami cacid(TXA)on blood loss in total hip arthroplasty(THA).Methods The 90 primary unilateral THA patients were randomly divided into group A(20 ml NS containing 1.0 g TXA,intraoperative topical infiltration two times+50 ml NS containing 1.0 g TXA,reverse perfusion by drainage tube after skin closed),group B(20 ml NS containing 1.0 g TXA,intraoperative topical infiltration two times+50 ml NS reverse perfusion by drainage tube after skin closed)and group C(20 ml NS intraoperative topical infiltration two times+50 ml NS containing 1.0 g TXA reverse perfusion by drainage tube after skin closed)(n=30,respectively).The solution was performed intraoperative topical infiltration and postoperative reverse perfusion by drainage tube after skin closed,respectively.The intraoperative blood loss,postoperative drainage,hemoglobin(Hb)of postoperative 3 d,the number of deep vein thrombosis(DVT)were recorded.Results There were no significantly differences in the intraoperative blood loss of group A and group B(P>0.05),which were both significantly less than that of group C respectively(P<0.05).There were no statistically differences in the postoperative drainage of group A and group C(P>0.05),which was significantly less than that of group B,respectively(P<0.05).The Hb of postoperative 3 d of group A was significantly higher than that of group B and group C,respectively(P<0.05),while there was no significant differences in that of group B and group C(P>0.05).There were no DVT in the three groups.Conclusions The topical application of TXA can reduce the blood loss of primary unilateral THA.The method of topical infiltration can reduce the intraoperative blood loss,while the method of reverse perfusion by drainage tube can reduce the postoperative drainage.The combined topical application of TXA can conduct a better effect.

关 键 词：氨甲环酸 全髋关节置换术 局部浸润 引流管逆行灌注 失血量 

分 类 号：R687.4[医药卫生—骨科学] R973.1[医药卫生—外科学]