初次全髋关节置换术患者静脉联合局部应用氨甲环酸对围手术期出血的影响  

Effect of intravenous tranexamic acid combined with local application on perioperative hemorrhage in patients undergoing primary total hip arthroplasty

作　　者：伍爱平 罗志环[1] 陈剑平[1] 杨康华[1] WU Ai-ping;LUO Zhi-huan;CHEN Jian-ping;YANG Kang-hua(Ganzhou People's Hospital,Department of Sports Medicine,Ganzhou,Jiangxi 341000)

机构地区：[1]赣州市人民医院运动医学科,江西赣州341000

出　　处：《赣南医学院学报》2021年第7期681-683,702,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨初次全髋关节置换术患者静脉联合局部应用氨甲环酸对围手术期出血的影响。方法:选取2017年7月至2020年6月接受初次单侧人工全髋关节置换手术的患者,根据是否应用氨甲环酸分为观察组和对照组。观察组在手术切开皮肤前10 min静脉滴注20 mg·kg^(-1)氨甲环酸,并在关闭切口前将1 g氨甲环酸局部注射入筋膜下和肌肉内,对照组未应用氨甲环酸。对两组的手术时间、围手术期出血量、输血率、下肢深静脉血栓发生率进行分析。结果:观察组出血量和输血率少于对照组,差异有统计学意义(P<0.05)。两组手术时间和深静脉血栓发生率差异均无统计学意义(P>0.05)。结论:静脉和局部联合应用氨甲环酸可显著减少全髋关节置换术患者术中和术后出血量,并且降低输血率,氨甲环酸不会增加下肢深静脉血栓形成的风险。Objective:To investigate the effect of intravenous tranexamic acid combined with local application on perioperative hemorrhage in patients undergoing primary total hip arthroplasty.Methods:From July 2017 to June 2020,patients undergoing the first unilateral total hip arthroplasty were selected and divided into observation group and control group according to the application of tranexamic acid.In the observation group,20 mg·kg^(-1) tranexamic acid was intravenously infused 10 minutes before skin incision,and 1 g tranexamic acid was injected into the fascia and muscle before the incision was closed.Tranexamic acid was not used in the control group.The operation time,perioperative hemorrhage,blood transfusion rate and the incidence of deep venous thrombosis in the two groups were statistically analyzed.Results:The hemorrhage and blood transfusion rate of the observation group were less than those of the control group,and the difference was statistically significant(P<0.05).The operation time and the incidence of deep venous thrombosis between the two groups had no statistical difference(P>0.05).Conclusion:Intravenous and local application of tranexamic acid could significantly reduce intraoperative and postoperative hemorrhage and blood transfusion rate in patients undergoing total hip arthroplasty.Tranexamic acid did not increase the risk of deep venous thrombosis of lower extremity.

关 键 词：氨甲环酸 全髋关节置换 出血 输血 

分 类 号：R687.4[医药卫生—骨科学]