氨甲环酸对跟骨骨折围手术期失血量及术后恢复的影响  

Effect of tranexamic acid on perioperative blood loss and postoperative recovery of calcaneal fracture

作　　者：姜世斌 毛兆光[1] 毛建华 JIANG Shibin;MAO Zhaoguang;MAO Jianhua(Department of Orthopedics,Jiangshan Branch of Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,JiangShan 324100,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院江山分院、江山市人民医院骨科,浙江江山324100

出　　处：《全科医学临床与教育》2020年第12期1099-1101,1109,共4页Clinical Education of General Practice

基　　金：衢州市科技计划项目(2015C1006698)。

摘　　要：目的研究术前使用氨甲环酸对跟骨骨折围手术期失血量及术后恢复的影响。方法选择Sanders分型Ⅲ~Ⅵ型单侧闭合性跟骨骨折患者56例,按有无术前接受氨甲环酸治疗分为治疗组28例与对照组28例,均由同组医生手术治疗,观察两组围手术期失血量、引流管引流情况、切口干燥时间、切口健康等级、并发症发生率、术后凝血功能、血栓形成等情况。结果治疗组在围手术期失血量、术后引流量、切口干燥时间、术后并发症发生率均低于对照组,切口健康等级优于对照组(t分别=7.15、3.95、3.11,χ^2=4.29,Z=-2.10,P均<0.05),两组患者在术后纤维蛋白原(Fib)、凝血酶原时间(PT)、活化的部分凝血酶时间(APTT)、D-二聚体、术后深静脉血栓发生率比较,差异均无统计学意义(t分别=0.98、0.99、0.51、0.46,χ^2=0.15,P均>0.05)。结论跟骨骨折手术术前使用氨甲环酸治疗可减少围手术期失血量及术后引流量、促进切口干燥愈合、增加切口健康等级,减少术后并发症发生率,且不影响术后凝血功能,不增加血栓性疾病的风险。Objective To investigate the effect of preoperative tranexamic acid on perioperative blood loss and postoperative recovery of patient with calcaneal fractures.Methods Totally 56 patients with unilateral closed calcaneal fractures of sanders typeⅢ~Ⅵwere selected and divided into treatment group and control group according to whether they received tranexamic acid treatment before surgery with 28 cases in each.The perioperative blood loss,drainage situation of drainage tube,incision drying time,incision healthy level,complication rate,postoperative coagulation function,and thrombosis of the two groups were observed.Results The blood loss during the perioperative period,postoperative drainage volume,incision drying time,and postoperative complication rate in the experimental group were all lower than those in the control group,and incision health level was better than that in the control group(t=7.15,3.95,3.11,χ^2=4.29,Z=-2.10,P<0.05).There was no significant difference between the two groups in terms of coagulation function after surgery,and occurrence of thrombotic disease after surgery(t=0.98,0.99,0.51,0.46,χ^2=0.15,P>0.05).Conclusion The use of tranexamic acid treatment before calcaneal fracture surgery can reduce perioperative blood loss and postoperative drainage,promote incision healing and drying,increase the health level of the incision,reduce the incidence of postoperative complications,and there is no affect to the coagulation function after surgery and does not increase the risk of thrombotic disease.

关 键 词：跟骨骨折 氨甲环酸 围手术期失血量 术后恢复 

分 类 号：R687.3[医药卫生—骨科学]