全髋/全膝人工关节置换围术期应用氨甲环酸的有效性及安全性分析  

Analysis of efficacy and safety of tranexamic acid in the treatment of total hip/total knee arthroplasty during the perioperative period

作　　者：宋朝基 苗生龙 狄天宁[3] 李柱山 李兴成 Song Chaoji;Miao Shenglong;Di Tianning;Li Zhushan;Li Xingcheng(The Second Department of Surgery,the People's Hospital of Tianzhu County,Wuwei City,Gansu Province,Gansu Wuwei 733299;The first Department of Orthopedics,the People's Hospital of Wuwei City,Gansu Province,Gansu Wuwei 733000;Department of Orthopedics,the Second Hospital of Lanzhou University,Gansu Lanzhou 730030)

机构地区：[1]甘肃省武威市天祝县人民医院外二科,甘肃武威733299 [2]甘肃省武威市人民医院骨一科,甘肃武威733000 [3]兰州大学第二医院骨科,甘肃兰州730030

出　　处：《中国社区医师》2020年第24期64-65,共2页Chinese Community Doctors

摘　　要：目的:评价全髋或全膝关节置换患者围手术期应用氨甲环酸的有效性和安全性。方法:2016年12月-2019年6月收治全髋或全膝关节置换患者200例,按照围手术期是否应用氨甲环酸及剂量分为空白对照组,1000 mg以下组,1000~2000 mg组及2000 mg以上组。建立多层多变量回归模型分析围手术期应用氨甲环酸与手术结果的相关性。结果:氨甲环酸组围手术期输血率、血栓形成率、急性肾衰竭率及复合并发症发病率均显著低于无氨甲环酸组,差异有统计学意义(P<0.05)。与其他剂量组相比,1000~2000 mg氨甲环酸组具有更高有效性和安全性。结论:氨甲环酸在降低患者围手术期输血概率的同时,不会增加术后血栓形成和急性肾衰竭等并发症发生风险。Objective:To evaluate the efficacy and safety of tranexamic acid in the treatment of patients with total hip or total knee arthroplasty during the perioperative period.Methods:From December 2016 to June 2019,200 patients with total hip or total knee arthroplasty were selected and they were divided into the blank control group,less than 1000 mg group,1000 mg to 2000 mg group and more than 2000 mg group according to whether tranexamic acid was applied and the dose during the perioperative period.A multi-layer multivariate regression model was established to analyze the correlation between the application of tranexamic acid and the operative results during the perioperative period.Results:The perioperative transfusion rate,thrombosis rate,acute renal failure rate and the incidence of complex complications in the tranexamic acid group were significantly lower than the without tranexamic acid group,the differences were statistically significant(P<0.05).Compared with other dose groups,the 1000 mg to 2000 mg group of tranexamic acid had higher efficacy and safety.Conclusion:Tranexamic acid does not increase the risk of postoperative complications such as thrombosis and acute renal failure while reducing the risk of perioperative blood transfusion.

关 键 词：全髋关节置换 全膝关节置换 氨甲环酸 输血 血栓形成 急性肾衰竭 

分 类 号：R687.4[医药卫生—骨科学]