氨甲环酸对初次单侧人工全膝关节置换术后失血的疗效观察  

Effect of tranexamic acid on blood loss after primary unilateral total knee arthroplasty

作　　者：席向东 王硕 杨超[1] 张晨[1] 宋国瑞 陈德胜[2] XI Xiangdong;WANG Shuo;YANG Chao;ZHANG Chen;SONG Guorui;CHEN Desheng(Ningxia Medical University,Yinchuan 750004,China;General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学总医院骨一科,宁夏银川750004

出　　处：《宁夏医学杂志》2020年第3期217-219,共3页Ningxia Medical Journal

摘　　要：目的探讨关节腔内局部应用氨甲环酸对初次人工全膝关节置换术后失血量的影响。方法将因膝骨性关节炎行初次人工全膝关节置换术患者70例随机分为A、B组,每组35例。A组在缝合关节囊后经引流管向关节腔注射氨甲环酸;B组在缝合关节囊后不注射氨甲环酸。2组患者术后夹闭引流管6 h后打开。记录2组患者术中失血量、术后24 h血红蛋白水平、红细胞压积、术后引流量、隐性失血量、总失血量等。结果术前2组患者性别、年龄、体重指数(BMI值)、血红蛋白(Hb)及红细胞压积(Hct)等比较差异均无统计学意义(P>0.05)。术中出血量、显性出血量A组小于B组,差异无统计学意义(P>0.05);术后Hct、术后引流量、总失血量、隐性失血量A组小于B组,差异有统计学意义(P<0.05);2组患者在术后均未发生下肢深静脉血栓。结论关节腔局部应用氨甲环酸可有效减少全膝关节置换术后总失血量、术后引流量及隐性失血量,且不会增加术后血栓形成的风险。Objective To investigate the effect oftranexamic acid on blood loss after primary total knee arthroplasty.Methods 70 patients with osteoarthritis of the knee who performed primary total knee arthroplasty were randomly divided into group A and group B,35 cases in each group. Tranexamic acid was injected into the joint cavity through a drainage tube after suturing the joint capsule in group A;Tranexamic acid was not injected into the joint capsule in group B. The drainage tubes were opened 6 hours later after the operation. The intraoperative blood loss,24-hour hemoglobin level,hematocrit,postoperative drainage volume,recessive blood loss and total blood loss were recorded.Results There was no significant difference in sex,age,BMI,Hb and Hct betweentwo groups(P>0.05);Intraoperative blood loss and dominant blood loss in group A was less than group B,there was no significant difference(P>0.05);The postoperative Hct,postoperative drainage,total blood loss,and recessive blood loss in group A was less than group B,and the difference was statistically significant(P<0.05). No deep vein thrombosis occurred in both groups.Conclusion Tranexamic acid applied locally to the joint cavity can effectively reduce the total blood loss,postoperative drainage volume and latent blood loss after total knee arthroplasty without increasing the risk of thrombosis.

关 键 词：氨甲环酸 全膝关节置换术 隐性失血 

分 类 号：R758.4[医药卫生—皮肤病学与性病学]