单髁关节置换术中局部应用骨蜡及氨甲环酸对术后出血及短期膝关节功能的影响分析  

Effect of Local Application of Bone Wax and Tranexamic Acid on Postoperative Bleeding and Short-Term Knee Function during Unicondylar Arthroplasty

作　　者：孙少松 卢文海 史思峰 SUN Shaosong;LU Wenhai;SHI Sifeng(The Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院,江苏徐州221000

出　　处：《河北医学》2022年第12期2017-2022,共6页Hebei Medicine

基　　金：江苏省科技基础研究计划(自然科学基金)项目,(编号:BK20201154)。

摘　　要：目的:在单髁关节置换术中局部应用骨蜡及氨甲环酸,分析该方案对患者术后出血、短期膝关节功能的影响。方法:选取2020年4月至2021年10月在本院接受单髁关节置换术的84例患者作为此次研究对象,采用简单随机分组法,通过抽签形式将患者分为四组,各21例,A组采用加压包扎处理,B组采用骨蜡,C组采用氨甲环酸,D组采用骨蜡联合氨甲环酸。对比四组的出血量、术前及术后1周血红蛋白和凝血功能、术前及术后1周、1个月膝关节功能。结果:B组、C组、D组的术中失血量、术后失血量、围手术期总失血量均低于A组(P<0.05),C组和D组的出血量低于B组(P<0.05),而C组和D组对比差异无统计学意义(P>0.05)。术后1周,B组、C组、D组的血红蛋白(HB)、纤维蛋白原(FIB)均高于A组(P<0.05),C组和D组均高于B组(P<0.05),但C组和D组对比差异无统计学意义(P>0.05)。术后1周、1个月,四组的膝关节HSS评分对比差异无统计学意义(P>0.05)。结论:在单髁关节置换术中局部应用骨蜡或氨甲环酸,均能减少患者的出血量,但止血效果氨甲环酸、骨蜡联合氨甲环酸优于单一应用骨蜡,且不会影响膝关节功能恢复。Objective:The effect of bone wax and tranexamic acid on postoperative bleeding and short-term knee function during unicondylar arthroplasty was analyzed.Methods:A total of 84 patients who underwent unicondylar joint replacement in our hospital from April 2020 to October 2021 were selected as the research subjects.The patients were divided into 4 groups by lottery technique with simple random method,with 21 cases in each group.Group A received compression dressing,group B received bone wax,group C received tranexamic acid,and group D received bone wax combined tranexamic acid.The amount of blood loss,hemoglobin and coagulation function before and 1 week after operation,and knee function before and 1 week and 1 month after operation were compared in 4 groups.Results:The intraoperative blood loss,postoperative blood loss and perioperative total blood loss in groups B,C and D were lower than those in group A(P<0.05),while the blood loss in groups C and D was lower than that in group B(P<0.05),and there was no statistical significance between group C and group D(P>0.05).One week after operation,hemoglobin(HB)and fibrinogen(FIB)in groups B,C and D were higher than those in group A(P<0.05),and those in groups C and D were higher than those in group B(P<0.05),but there was no statistical significance between group C and group D(P>0.05).1 week and 1 month after surgery,there was no significant difference in HSS scores of knee joints among the 4 groups(P>0.05).Conclusion:Topical application of bone wax or tranexamic acid in monondylar joint replacement can reduce the amount of blood loss in patients,but tranexamic acid and bone wax combined with tranexamic acid has better hemostatic effect than bone wax alone,and does not affect the recovery of knee function.

关 键 词：单髁关节置换 术中局部应用 骨蜡 氨甲环酸 术后出血 膝关节功能 

分 类 号：R687.4[医药卫生—骨科学]