氨甲环酸对全膝关节表面置换术术后失血量及近期预后效果的研究  

The effect of tranexamic acid on the blood loss and the short-term prognosis after resurfacing total knee arthroplasty

作　　者：江洪耿 黄武斌[1] 郑宁[1] 李裕祥[1] 陈镇鑫 JIANG Honggeng;HUANG Wubin;ZHENG Ning;LI Yuxiang;CHEN Zhenxin(Department of Orthopedic Surgery,ZoneⅠ,Jieyang People's Hospital in Guangdong Province,Jieyang522095,China)

机构地区：[1]广东省揭阳市人民医院骨外科一区,广东揭阳522095

出　　处：《中国现代医生》2020年第28期102-104,109,共4页China Modern Doctor

摘　　要：目的探讨氨甲环酸对全膝关节表面置换术术后失血量及近期预后的效果。方法选取2018年3月~2020年3月我院收治的全膝关节表面置换患者68例,随机设为研究组(n=34)与对照组(n=34),对照组应用常规治疗,研究组应用氨甲环酸治疗。比较两组患者的血红蛋白与红细胞指标,静脉血栓与下肢肿痛的发生率及VAS评分。结果研究组患者治疗7 d后血红蛋白指标为(130.1±1.5)g/L、红细胞为(460.5±11.5)万/mm^3,优于对照组的血红蛋白(110.2±1.2)g/L、红细胞为(380.2±11.9)万/mm^3(P<0.05);研究组静脉血栓发生率为5.8%,下肢肿痛发生率为2.9%,显著低于对照组的17.6%与11.8%(P<0.05);研究组患者的术后3个月的VAS评分为(1.8±1.3)分低于对照组的(2.7±1.5)分(P<0.05)。结论在全膝关节表面置换术中应用氨甲环酸,患者术后的血红蛋白与红细胞指标明显提高,且患者的静脉血栓与下肢肿痛发生率显著降低,患者的疼痛感较轻,可在临床中推广应用。Objective To explore a study of the effect of tranexamic acid on the blood loss and the short-term prognosis after resurfacing total knee arthroplasty.Methods From March 2018 to March 2020,a total of 68 patients having undergone resurfacing total knee arthroplasty admitted to and treated in our hospital were selected and randomly taken as the study group(n=34)and the control group(n=34).The control group was given conventional treatment,while the study group was treated with tranexamic acid.The indexes of hemoglobin(Hb)and red blood cell(RBC),the incidences of venous thrombosis(VT)and lower limb swelling and pain and the VAS scores were compared between the two groups.Results After 7 d of treatment,the index of Hb of the patients in the study group was(130.1±1.5)g/L,and that of RBC was(460.5±11.5)million/mm3,respectively superior to the(110.2±1.2)g/L and the(380.2±11.9)million/mm3(P<0.05)in the control group.The incidence of VT of the study group was 5.8%,and the incidence of lower limb swelling and pain was 2.9%,significantly lower than the 17.6%and 11.8%of the control group(P<0.05).The VAS scores of the patients in the study group 3 months after operation were(1.8±1.3)points,lower than the(2.7±1.5)points in the control group(P<0.05).Conclusion With the application of tranexamic acid to resurfacing total knee arthroplasty,the indexes of Hb and RBC of the patients after operation significantly increase,while the incidences of VT and lower limb swelling and pain of the patients significantly decrease,and the patients have milder pain.The therapy can be promoted and applied in clinical practice.

关 键 词：氨甲环酸 全膝关节 表面置换术 失血量 

分 类 号：R687.42[医药卫生—骨科学]