全髋关节置换术中体温变化对氨甲环酸止血作用的影响探讨  

Clinical study of body temperature changes on the hemostatic effect of tranexamic acid during total hip arthroplasty

作　　者：黄宇[1] 罗毅[1] 黄晓[1] 尹东[1] 李富林[1] 黄文文[1] HUANG Yu;LUO Yi;HUANG Xiao(Department of Orthopedics,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院骨科

出　　处：《中国临床新医学》2019年第10期1087-1090,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西卫健委课题项目(编号:卫Z2016597);广西医疗卫生适宜技术研究与开发项目(编号:卫S201544);广西科技计划项目(编号:桂科AB16380230)

摘　　要：目的探讨全髋关节置换术(THA)围术期中患者体温变化对氨甲环酸(TXA)止血作用的影响。方法选取2016-11~2018-09在该院行单侧THA患者60例,按入院顺序分为研究组和对照组,每组30例。研究组患者术中应用医用可控式保温毯、医用输血输液加温器、调节手术室环境温度等措施使患者体温保持在36℃以上;对照组不做特殊体温保护措施。比较两组术中失血量情况以及术后输血率等情况。结果研究组术中失血量、术后引流量及隐性失血量均少于对照组,差异有统计学意义(P<0.05)。研究组术后即刻血红蛋白水平和术后第3天血红蛋白水平高于对照组,术后凝血酶原时间和输血率低于对照组,差异有统计学意义(P<0.05)。结论THA患者术中体温维持正常可以促进TXA发挥止血功效,减少患者术中、术后失血量及隐性失血量,降低输血率。Objective To investigate the effect of body temperature changes on hemostasis using tranexamic acid(TXA)during the perioperative period of total hip arthroplasty(THA).Methods Sixty patients receiving unilateral THA for the first time in our hospital from November 2016 to September 2018 were selected.The patients were divided into study group and control group according to the order of hospitalization,with 30 cases in each group.In the study group,the medical controllable thermal insulation blanket,the medical transfusion and infusion warmer,and the adjustment of the operating room ambient temperature were used to keep the patients′body temperature above 36℃.However,the control group did not take any special temperature protection measures.The blood loss during the operation and the postoperative blood transfusion rate were compared between the two groups.Results The intraoperative blood loss,amount of postoperative drainage and occult blood loss in the study group were significantly less than those in the control group(P<0.05).The hemoglobin levels of the study group were significantly higher than those of the control group immediately after the operation and 3 days after the operation.The postoperative prothrombin time in the study group was significantly shorter than that in the control group(P<0.05).The postoperative blood transfusion rate of the study group was significantly lower than that of the control group(P<0.05).Conclusion Maintaining the normal intraoperative body temperature of THA patients can promote the hemostatic effect of TXA,reduce intraoperative and postoperative blood loss and recessive blood loss,and reduce the rate of blood transfusion.

关 键 词：全髋关节置换术 体温 氨甲环酸 止血 

分 类 号：R687.4[医药卫生—骨科学]