围手术期应用氨甲环酸对骨科大手术失血量的影响  

Effect of tranexamic acid on blood loss in orthopaedic surgery during perioperative period

作　　者：赵东风 张泳照 王俊生 尹健石 闫寒 武旭阳 ZHAO Dong-feng;ZHANG Yong-zhao;WANG Jun-sheng(Department of Orthopaedics,The 967th Hospital of the Joint Logistics Support Force of the People's Liberation Army,Dalian 116000,China)

机构地区：[1]解放军联勤保障部队第967医院骨科,116000

出　　处：《中国实用医药》2020年第34期113-115,共3页China Practical Medicine

摘　　要：目的探讨围手术期应用氨甲环酸对骨科大手术失血量的影响。方法将80例骨科大手术患者,按随机数字表法分为氨甲环酸组及对照组,各40例。两组均进行一般治疗,氨甲环酸组在一般治疗基础上加用氨甲环酸ABC综合治疗法。比较两组手术相关指标、术后随访情况、术后并发症发生情况。结果两组手术时间比较差异无统计学意义(P>0.05);氨甲环酸组术后6 h引流量(195.01±9.81)ml、输血量(521.45±45.81)ml少于对照组的(275.37±8.69)、(870.23±50.64)ml,平均住院日(9.57±1.34)d短于对照组的(11.28±2.16)d,差异均有统计学意义(P<0.05)。两组患者均获12个月的随访,术中及术后均未出现手术并发症导致死亡的患者及其他原因失访。随访期间两组均未发生双下肢静脉血栓、肺栓塞等。氨甲环酸组并发症发生率为7.5%(3/40),与对照组的17.5%(7/40)比较,差异无统计学意义(P>0.05)。结论对于在骨科大手术围手术期综合应用氨甲环酸,可以达到有效少总失血量以及减少输血量的临床目的 ,并且未增加下肢深静脉血栓形成等危险,更有利于患者的术后恢复。Objective To discuss the effect of tranexamic acid on blood loss in orthopaedic surgery during perioperative period. Methods A total of 80 patients with orthopaedic surgery were divided into tranexamic acid group and control group according to random numerical table, with 40 cases in each group. Both groups received general treatment, and the tranexamic acid group was also received tranexamic acid ABC comprehensive treatment. The surgery related indicators, postoperative follow-up, and occurrence of postoperative complications were compared between the two groups. Results There was no statistically significant difference in surgery time between the two groups(P>0.05). The drainage volume 6 h after surgery(195.01±9.81) ml and blood transfusion volume(521.45±45.81) ml of tranexamic acid group were less than(275.37±8.69) and(870.23±50.64) ml of the control group, and hospitalization time(9.57±1.34) d was shorter than(11.28±2.16) d of the control group, and the difference was statistically significant(P<0.05). Patients in both groups were followed up for 12 months. There were no deaths or loss of follow-up due to complications during and other reasons. During the follow-up period, there were no venous thrombosis of lower extremities and pulmonary embolism in both groups. The incidence of complications of tranexamic acid group was 7.5%(3/40), which had no statistically significant difference compared with 17.5%(7/40) of the control group(P>0.05). Conclusion The comprehensive application of tranexamic acid during the perioperative period of major orthopedic surgery can effectively reduce total blood loss and blood transfusion without increasing the risk of deep vein thrombosis of the lower extremities, which is more conducive to the postoperative recovery of patients.

关 键 词：骨科手术 氨甲环酸 围术期 

分 类 号：R687.3[医药卫生—骨科学]