氨甲环酸不同用药方式对女性股骨颈骨折全髋关节置换术失血量的影响  

Effects of different medications of tranexamic acid on blood loss after total hip replacement in women with femoral neck fractures

作　　者：胡继苏 HU Jisu(The First People's Hospital of Yidu,Hubei Province,Yidu 443300,China)

机构地区：[1]湖北省宜都市第一人民医院,443300

出　　处：《临床合理用药杂志》2021年第34期23-25,28,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察氨甲环酸不同用药方式对女性股骨颈骨折全髋关节置换术失血量的影响。方法选择2018年4月-2020年4月湖北省宜都市第一人民医院收治的女性股骨颈骨折患者108例,均行全髋关节置换术治疗。采用随机数字表法分为4组各27例,观察Ⅰ组围术期给予氨甲环酸静脉滴注,观察Ⅱ组围术期给予氨甲环酸局部用药,观察Ⅲ组围术期给予氨甲环酸静脉滴注联合局部用药,对照组未给予氨甲环酸用药。比较4组患者切口引流量、失血量(显性失血量、隐性失血量、总失血量),术前、术后72 h血红蛋白(Hb)水平、凝血功能指标[凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、国际标准化比值(INR)]及并发症(切口渗血、皮肤淤斑、下肢深静脉血栓及肺栓塞)。结果 4组患者伤口引流量比较差异无统计学意义(P> 0.05);观察Ⅰ组、Ⅱ组、Ⅲ组显性失血量、隐性失血量及总失血量均低于对照组,且观察Ⅲ组低于观察Ⅰ组、Ⅱ组(P<0.05)。术后72 h,4组患者Hb水平均低于术前,但观察Ⅲ组Hb水平高于对照组、观察Ⅰ组、观察Ⅱ组(P<0.05)。术前、术后72 h,4组患者PT、APTT、INR比较差异均无统计学意义(P> 0.05)。4组并发症总发生率比较差异无统计学意义(P> 0.05)。结论行全髋关节置换术治疗的女性股骨颈骨折患者围术期给予氨甲环酸静脉用药联合局部用药可有效控制失血量,减少血红蛋白变化,且对引流量、凝血功能无影响,不增加并发症,值得临床推广应用。Objective To observe the effects of different medications of tranexamic acid on blood loss after total hip replacement in women with femoral neck fractures.Methods From April 2018 to April 2020, 108 female patients with femoral neck fractures admitted to the First People′s Hospital of Yidu, Hubei Province were selected, all of them underwent total hip arthroplasty. Using random number table method, they were divided into 4 groups with 27 cases in each group.Observation group Ⅰ was given tranexamic acid intravenous drip during the perioperative period, observation group Ⅱ was given local tranexamic acid during the perioperative period, and observation group Ⅲ was given intravenous tranexamic acid combined with local medication during the perioperative period, control group did not give tranexamic acid medication. Compared the incision drainage volume, blood loss(dominant blood loss, recessive blood loss, total blood loss), hemoglobin(Hb) levels before and 72 hours after surgery, and blood coagulation function indexes[ prothrombin time( PT), partially activated prothrombin time(APTT), international normalized ratio(INR)] and complications(incision bleeding, skin ecchymosis, deep vein thrombosis and pulmonary embolism) of the 4 groups.Results There was no statistically significant difference in wound drainage between the 4 groups(P> 0. 05);The apparent blood loss, hidden blood loss and total blood loss of observation group Ⅰ, group Ⅱ, and group Ⅲ were lower than those of control group, and observation group Ⅲ was lower than observation groupⅠand groupⅡ(P<0. 05). At 72 hours after operation, the Hb level of the 4 groups was lower than that before the operation, but the Hb level of the observation group Ⅲ was higher than that of the control group, observation groupⅠand observation groupⅡ(P<0. 05). There was no significant difference in PT, APTT, and INR between the 4 groups before and 72 hours after operation(P>0. 05). There was no significant difference in the total incidence of complication

关 键 词：股骨颈骨折 女性 全髋关节置换术 氨甲环酸 失血量 

分 类 号：R687.4[医药卫生—骨科学]