单侧初次全膝关节置换术静脉与关节腔内联合应用氨甲环酸止血疗效的临床研究  

Clinical Study on the Combined Use of Tranexamic Acid for Hemostasis in Unilateral Primary Total Knee Arthroplasty Combined with Intravenous and Intra-articular Cavity

作　　者：王建坤 WANG Jian-kun(Department of Orthopaedics,Fuzhou Second Hospital Affiliated to Xiamen University,Xiamen,Fujian Province,350007 China)

机构地区：[1]厦门大学附属福州第二医院骨科,福建厦门350007

出　　处：《中外医疗》2019年第5期131-134,共4页China & Foreign Medical Treatment

摘　　要：目的分析研讨单侧初次全膝关节置换术静脉联合关节腔内应用氨甲环酸止血的临床疗效。方法从该院2016年4月—2018年5月期间收治的单侧初次全膝关节置换术患者中随机抽取80例做回顾资料分析,患者均接受氨甲环酸治疗,依据其氨甲环酸给药方式分组,其中40例为静脉滴注(对照组),另40例接受静脉滴注联合关节腔内注射(研究组),观察比较两组患者治疗效果,如止血状况等。结果研究组并发症总发生率7.50%虽略低于对照组10.00%,但组间数据差异无统计学意义(χ~2=0.156 6,P=0.692 3)。研究组术后输血率0.00%(0/40)低于对照组20.00%(8/40),组间数据差异有统计学意义(χ~2=8.888 9,P=0.002 9);研究组显性失血量、隐性失血量、总失血量均低于对照组,组间数据差异有统计学意义(t=9.409 4、6.741 7、4.700 2,P=0.000 0、0.000 0、0.000 0)。比较D-二聚体、APPT、PT指标,组间数据差异无统计学意义(t=0.728 7、0.524 2、0.818 5,P=0.468 3、0.601 6、0.415 6)。结论建议临床在单侧初次全膝关节置换术中应用氨甲环酸药物时,给药途径可为静脉联合关节腔内注射,与单一的静脉给药比较,联合给药在降低出血量和血栓风险性方面作用更为突出,有推广价值。Objective To analyze the clinical efficacy of unilateral primary total knee arthroplasty combined with intra-articular injection of tranexamic acid for hemostasis.Methods A retrospective analysis of 80 patients who underwent unilateral primary total knee arthroplasty from April 2016 to May 2018 in our hospital was performed.All patients received tranexamic acid treatment according to their tranexamic acid.The drug group was divided into 40 cases of intravenous infusion(control group),and the other 40 cases received intravenous infusion combined with intra-articular injection(study group),and the treatment effects of the two groups were observed,such as hemostasis.Results The total incidence of complications in the study group was 7.50%,which was slightly lower than that of the control group(10.00%),but the data were not statistically significant(χ^2=0.156 6,P=0.692 3).The postoperative blood transfusion rate of the study group was 0.00%(0/40)lower than that of the control group 20.00%(8/40).The data between the groups was statistically significant(χ^2=8.888 9,P=0.002 9);the study group showed significant blood loss,hidden amount of blood loss and total blood loss were lower than the control group,and the data between the groups were statistically significant(t=9.409 4,6.741 7,4.700 2,P=0.000 0,0.000 0,0.000 0).The D-dimer,APPT,and PT indicators were compared.There was no statistically significant difference between the groups(t=0.728 7,0.524 2,0.818 5,P=0.468 3,0.601 6,0.415 6).Conclusion It is recommended that the clinical application of tranexamic acid in the unilateral primary total knee arthroplasty can be intravenously combined with intra-articular injection.Compared with single intravenous administration,combined administration reducing bleeding volume and thrombosis risk is more prominent and has promotional value.

关 键 词：关节腔内 静脉 氨甲环酸 单侧初次全膝关节置换术 止血 

分 类 号：R687.4[医药卫生—骨科学]