氨甲环酸在Campanacci Ⅱ级肱骨骨巨细胞瘤外科治疗中的应用  

Application of tranexamic acid in surgical treatment of Campanacci Ⅱ grade humerus giant cell tumor

作　　者：李勇[1] 张剑锋[1] 闫明[1] 安毅[1] 梁守磊 翟晓娜 王保苍[1] LI Yong;ZHANG Jianfeng;YAN Ming;AN Yi;LIANG Shoulei;ZHAI Xiaona;WANG Baocang(Department of Osteopathy,the Second Hospital of Tangshan,Hebei Tangshan 063000,China;Second Department of Joint Surgery,the Second Hospital of Tangshan,Hebei Tangshan 063000,China)

机构地区：[1]唐山市第二医院骨病科,河北唐山063000 [2]唐山市第二医院关节二科,河北唐山063000

出　　处：《现代肿瘤医学》2021年第5期860-863,共4页Journal of Modern Oncology

基　　金：河北省2020年度医学科学研究课题计划(编号:20201452)。

摘　　要：目的:探讨氨甲环酸在CampanacciⅡ级肱骨近端骨巨细胞瘤外科治疗中应用的有效性、安全性以及应用氨甲环酸对CampanacciⅡ级肱骨近端骨巨细胞瘤术后复发率及功能的影响。方法:收集2004年06月至2019年12月有完整资料的CampanacciⅡ级肱骨近端骨巨细胞瘤患者20例,均采用刮除骨水泥填充内固定术治疗。按照是否应用氨甲环酸分为两组,氨甲环酸组:手术切开皮肤前10 min,氨甲环酸20 mg/kg静脉滴注完毕,术后24 h内每间隔3~4 h给药1次(每次10 mg/kg)。对照组:手术前后均未应用氨甲环酸治疗。比较2组病人总失血量、术中出血量、术后引流量、隐性失血量、复发率及术后MSTS评分。结果:氨甲环酸组术中出血量(750.00±73.60)mL、术后引流量(277.00±40.43)mL、手术总失血量(1 121.30±74.85)mL、HCT差值(0.05±0.02)低于对照组术中出血量(877.50±93.13)mL、术后引流量(334.00±28.17)mL、手术总失血量(1 304.50±108.07)mL、HCT差值(0.09±0.02),结果具有统计学差异(P<0.05)。氨甲环酸组隐性失血量(94.30±13.10)mL与对照组(93.00±13.51)mL比较,结果无统计学差异(P> 0.05)。氨甲环酸组复发率(10%)与对照组(20%)比较,结果无统计学差异(P> 0.05)。氨甲环酸组MSTS评分[(28.20±1.14)分]与对照组[(28.40±0.97)分]比较,结果无统计学差异(P> 0.05)。结论:氨甲环酸在CampanacciⅡ级肱骨近端骨巨细胞瘤的刮除骨水泥填充术中应用是安全有效的,不仅降低手术总失血量、术中出血量、术后引流量,而且不影响肿瘤复发率及术后肢体功能恢复。可作为肱骨近端骨巨细胞瘤的新辅助治疗手段。Objective:To discuss on the efficacy and safety of tranexamic acid in surgical treatment of Campanacci Ⅱ grade proximal humerus giant cell tumor and effect of tranexamic acid on recurrence rate and function of Campanacci Ⅱ grade proximal humerus giant cell tumor.Methods:From June 2004 to December 2019,20 patients with Campanacci Ⅱ grade proximal humerus giant cell tumor were collected in this study,that were treated by internal fixation with scraping cement.There were two groups according to the application of tranexamic acid.Tranexamic acid group:An intravenous drip of tranexamic acid(20 mg/kg) was completed before incision in 10 minutes.To give tranexamic acid at each interval of 3~4 h in 24 h(10 mg/kg each) after surgical operation.Control group:Before and after the operation,those were no treatment of tranexamic acid.The total blood loss,intraoperative blood loss,postoperative drainage,recessive blood loss,recurrence rate and postoperative MSTS scores in the 2 groups were compared.Results:In the tranexamic acid group,the intraoperative blood loss(750.00±73.60)mL,postoperative drainage(277.00±40.43)mL,total blood loss(1 121.30±74.85)mL,HCT difference(0.05±0.02)mL were lower than those in the control group(877.50±93.13)mL,postoperative drainage(334.00±28.17)mL,total blood loss(1 304.50±108.07)mL and HCT difference(0.09±0.02),results have statistical differences(P<0.05).The recessive blood loss(94.30±13.10)mL in the tranexamic acid group was compared with the control group(93.00±13.51)mL.The results showed no statistical difference(P>0.05).Recurrence rate(10%) in the tranexamic acid group compared with the control group(20%),and the results showed no statistical difference(P>0.05).The MSTS score(28.20±1.14) scores of the tranexamic acid group was compared with that of the control group(28.40±0.97) scores,and the results showed no statistical difference(P>0.05).Conclusion:Application of tranexamic acid in cement filling of Campanacci Ⅱ grade proximal humerus giant cell tumor is safe and effect

关 键 词：氨甲环酸 骨巨细胞瘤 刮除术 复发 

分 类 号：R738.1[医药卫生—肿瘤]