关节腔内注射氨甲环酸减少关节镜下前交叉韧带重建术后关节内出血的短期效果  

Short-term efficacy of intra-articular injection of tranexamic acid to reduce intra-articular bleeding after arthroscopic anterior cruciate ligament reconstruction

作　　者：陈会会 李坚 潘玲 CHEN Huihui;LI Jian;PAN Ling(Department of Sports Medicine,the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fujian,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院运动医学科,福建福州350003

出　　处：《中国医药科学》2023年第15期186-190,共5页China Medicine And Pharmacy

摘　　要：目的探讨膝关节腔内注射氨甲环酸(TXA)减少关节镜下前交叉韧带重建(ACLR)术后关节内出血的短期效果。方法选择2021年6月至2022年3月就诊于福建中医药大学附属第二人民医院运动医学科诊断为前交叉韧带(ACL)损伤患者82例,采用随机数表法分为两组,每组各41例。两组均行解剖单束重建ACL治疗,试验组在术后予TXA 1 g加4℃生理盐水稀释至50 ml注射至患肢膝关节腔内,对照组仅注射4℃生理盐水50 ml,不加药物。记录术后24 h引流量;术后第1、3天和1个月分别采用测量膝关节活动度美国特种外科医院膝关节评分(HSS)、视觉模拟评分法(VAS)评分进行评价;术后1个月采用Lysholm评分进行评价。结果试验组术后24 h引流量明显减少,差异有统计学意义(P<0.05)。术后1 d,两组患者VAS评分、HSS评分差异无统计学意义(P>0.05),术后3 d试验组HSS评分明显高于对照组,差异有统计学意义(P<0.05),试验组VAS评分低于对照组,差异有统计学意义(P<0.05)。术后1个月,两组患者的HSS评分、VAS评分、Lysholm评分差异无统计学意义(P>0.05)。随访期间对照组出现2例术后关节肿胀需关节腔穿刺抽出积血治疗,两组患者均无出现感染、关节纤维化等其他并发症。结论关节腔内注射TXA可显著减少关节镜下ACLR术后24 h关节腔内出血、减轻术后早期疼痛,增加早期活动度。随访期间未发现不良反应及并发症,可认为其是一种相对安全的治疗方法。Objective To investigate the short-term efficacy of intra-articular injection of tranexamic acid(TXA)into the knee joint to reduce intra-articular bleeding after arthroscopic anterior cruciate ligament reconstruction(ACLR).Methods A total of 82 patients diagnosed with ACL injuries in the Department of Sports Medicine of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine from June 2021 to March 2022 were divided into 2 groups of 41 patients each according to the random number method.Both groups were treated with anatomical single bundle ACL reconstruction.The experimental group was injected with 50 ml TXA diluted by mixing 1 g of TXA with 4°C saline into the knee joint cavity of the affected limb after surgery,while the control group was injected with 50 ml of 4°C saline without any additional drugs.The flow of drainage 24 hours after surgery was recorded.The hospital for special surgery knee score(HSS)and the visual analogue scale(VAS)score were used to measure knee mobility on day 1,day 3 and 1 month after surgery respectively,and the Lysholm score was used 1 month after surgery.Results The 24-hour postoperative drainage was significantly reduced in the experimental group,with statistically significant difference(P<0.05).There were no significant differences between the two groups in VAS and HSS scores on day 1 after surgery(P>0.05),but the HSS scores were significantly higher and the VAS scores were significantly lower in the experimental group than in the control group on day 3 after s urgery,with statis tically significant differences(P<0.05).At 1 month after surgery,there were no significant differences between the two groups in HSS score,VAS score and Lysholm score(P>0.05).Two cases of postoperative joint swelling requiring aspiration for joint hematocele were observed in the control group during the follow-up period,and no infection,arthrofibrosis or other complications occurred in either group.Conclusion Intra-articular injection of TXA can significantly reduce intra-art

关 键 词：关节镜 前交叉韧带重建 氨甲环酸 关节积血 

分 类 号：R687.4[医药卫生—骨科学]