氨甲环酸不同给药途径对关节镜下肩袖修补术后中早期疼痛及功能恢复的影响  

Impact of administration route of tranexamic acid on pain and function of early and medium stage after arthroscopic rotator cuff repair

作　　者：于洋[1] 张晓刚 林源[1] 任世祥[1] 贾佳霖 张雨涵 张博[1] Yu Yang;Zhang Xiaogang;Lin Yuan;Ren Shixiang;Jia Jialin;Zhang Yuhan;Zhang Bo(Department of Orthopedic,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Orthopedic,Hebei Yanda Hospital,Langfang 065201,Hebei Province,China)

机构地区：[1]首都医科大学附属北京朝阳医院骨科,北京100020 [2]河北燕达医院骨科,河北廊坊065201

出　　处：《首都医科大学学报》2023年第3期475-481,共7页Journal of Capital Medical University

基　　金：河北省科技成果推广课题(20220966)。

摘　　要：目的通过随访评价氨甲环酸经不同给药途径对关节镜肩袖修补术后中早期疼痛及功能恢复的影响。方法回顾性分析2021年1月至2021年12月期间首都医科大学附属北京朝阳医院收治的肩袖损伤患者的临床资料,符合纳入标准的共64例,其中男性32例、女性32例,年龄39~70岁。术中采用关节注射、静脉应用和联合应用三种方式应用氨甲环酸,肩袖损伤采用双排缝线桥技术进行修补。比较分析患者术后1~3 d的疼痛视觉模拟评分(Visual Analogue Scale,VAS)和肩关节肿胀情况,术前、术后3个月及术后6个月的肩关节功能评分,以及术前、术后3 d、术后3个月及术后6个月的肩关节活动度。结果全部患者均顺利完成手术,术中及术后均未出现严重并发症。相较于静脉应用组及关节注射组,联合应用组在术后第1天及第2天VAS和肿胀情况方面效果更好(P<0.05);且在术后第3天的肩关节前屈、外展及外旋活动度方面效果更好(P<0.05)。在其余时间点的VAS、肿胀情况及功能评分方面,三组之间差异均无统计学意义(P>0.05)。结论术前静脉滴注联合术中关节注射相比于单纯术前静脉滴注及单纯关节注射,在改善患者术后疼痛、肿胀、活动度及功能方面效果更好。Objective To evaluate the impact of administration route of tranexamic acid on pain and function of early and medium stage after arthroscopic rotator cuff repair.Methods A retrospective analysis of clinical data of patients with rotator cuff tear in Beijing Chaoyang Hospital,Capital Medical University from January 2021 to December 2021.A total of 64 patients met the criteria,including 32 males and 32 females,aged 39-70 years.There were three administration routes of tranexamic acid,including intra-articular injection,intravenous drip and combined administration.Rotator cuff tear was repaired using double-row suture bridge technique.The Visual Analogue Scale(VAS)score and edema degree after surgery 1-3 d were analyzed.Function scores before surgery,3 months and 6 months after surgery were analyzed.Shoulder range of motion before surgery,3 d,3 months and 6 months after surgery were analyzed.Results All patients were successfully operated,no serious complication occurred during or after surgery.Compared with intra-articular injection group and intravenous group,the combined administration group showed better VAS score and edema degree after surgery 1 d and 2 d(P<0.05).Also,a better range of motion 3 d postoperative,including forward flexion,abduction and external rotation,was found(P<0.05).No other significant differences were found.Conclusions Combined administration of tranexamic acid can improve pain,edema,range of motion and function of shoulder after surgery better than intra-articular injection or intravenous drip alone.

关 键 词：肩袖损伤 氨甲环酸 关节镜 给药途径 

分 类 号：R686[医药卫生—骨科学]