三种止血方法对人工股骨头置换术失血量影响及安全性探讨  

Effect and safety of Tranexamic Acid infusion and irregular placement of drainage tube on blood loss in artificial femoral headreplacement

作　　者：杨达乐 朱江 毕兴林[1] YANG Dale;ZHU Jiang;BI Xinglin(Xinhui District Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Jiangmen Guangdong 529100,China)

机构地区：[1]广州中医药大学附属新会区中医院,广东江门529100

出　　处：《医药前沿》2021年第9期6-7,10,共3页Journal of Frontiers of Medicine

摘　　要：目的:探讨人工股骨头置换术采取关节腔内灌注氨甲环酸治疗并不常规放置引流管对失血量指标及安全性的影响。方法:选取2018年1月—2019年6月我院收治的102例拟行人工股骨头置换术治疗的患者,以随机数字表法分为甲、乙、丙三组,各34例。甲组术后予以常规放置引流管;乙组关节腔内灌注氨甲环酸,同时夹管2 h;丙组灌注氨甲环酸,并不常规放置引流管。对比三组患者围手术期的失血量情况以及并发症发生情况。结果:丙组总失血量为(342.25±31.78)mL,隐性失血量为(145.56±16.54)mL,显著低于甲组与乙组(P<0.05),丙组输血率为2.94%,较甲组与乙组显著降低(P<0.05);三组并发症发生率差异不显著(P>0.05)。结论:人工股骨头置换术采取关节腔内灌注氨甲环酸治疗并不常规放置引流管,有效减少了围手术期的失血量,且不会增加术后并发下肢静脉血栓的风险,值得应用。Objective To study the effect of Tranexamic Acid infusion in the articular cavity without routine drainage tube placement on blood loss indexes and safety of artificial femoral head replacement.Methods 102 patients who planned to undergo artificial femoral head replacement in our hospital on January,2018 and June,2019 were selected as the research subjects,and randomly divided into group A,group B and group C,with 34 cases in each group.In group A,drainage tubes were routinely placed after surgery.In group B,tranexamic acid was injected into the articular cavity and the tube was clamped for 2 h.Group C was injected with tranexamic acid,and drainage tubes were not routinely placed.The perioperative blood loss and the incidence of complications were compared among the three groups.Results The total blood loss and latent blood loss of group C were(342.25±31.78)mL and(145.56±16.54)mL,which were significantly lower than those of group A and group B.The blood transfusion rate of group C was 2.94%,which was significantly lower than that of group A and group B(P<0.05).The incidence of complications in group C was significantly lower than that in groups A and B(P<0.05).Conclusion Intraarticular transpiric acid perfusion is not routine drainage tube placement in artificial femoral head replacement,which effectively reduces perioperative blood loss and does not increase the risk of postoperative lower extremity venous thrombosis,and is worthy of promotion.

关 键 词：关节腔内灌注 氨甲环酸 引流管 人工股骨头置换术 失血量 

分 类 号：R687.3[医药卫生—骨科学]