氨甲环酸对跟骨骨折术后出血量的影响  

Effect of tranexamic acid on blood loss after calcaneal fracture surgery

作　　者：王欢[1] 谷鑫博 陈斌[2] 汪骋宇 孙海钰[1] WANG Huan;GU Xinbo;CHEN Bin;WANG Chengyu;SUN Haiyu(Department of Orthopedics,the Second Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西医科大学第二医院骨科,山西太原030001 [2]山西医科大学,山西太原030001

出　　处：《中国骨与关节损伤杂志》2024年第6期605-609,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察氨甲环酸对跟骨骨折术后出血量的影响。方法回顾性分析自2020-12-2022-12于山西医科大学第二医院骨科诊治的45闭合性跟骨骨折,根据有无应用氨甲环酸分为观察组(n=22)与对照组(n=23)。观察组术前静脉滴注100 mL氯化钠+1 g氨甲环酸,术中透视时及冲洗后于骨折断端涂抹氨甲环酸稀释液,缝合结束后沿引流管注射20 mL氨甲环酸稀释液;对照组术前静脉滴注100 mL氯化钠,术中透视时于骨折断端涂抹氯化钠,缝合结束后沿引流管注射20 mL氯化钠。记录两组术后连续3天的24 h内引流量、手术前后血红蛋白差值、术后切口并发症及下肢深静脉血栓形成情况。结果所有患者均获得随访,观察组随访时间3~12个月,平均7.69个月;对照组随访时间3~15个月,平均8.09个月。观察组出现5例切口皮缘发黑,对照组出现3例切口皮缘发黑,经积极非手术治疗后切口均愈合,两组术后均未出现下肢深静脉血栓形成。观察组术后血红蛋白含量高于对照组,且手术前后血红蛋白差值小于对照组,差异均有统计学意义(P<0.05)。观察组术后第1天、术后第2天引流量均明显小于对照组,差异有统计学意义(P<0.05),但两组术后第3天引流量差异无统计学意义(P>0.05)。结论应用氨甲环酸能够减少跟骨骨折术后失血量,并且不增加下肢深静脉血栓形成及切口并发症发生率,值得临床推广应用。Objective To observe the effect of tranexamic acid on blood loss after calcaneal fracture surgery.Methods A ret-rospective analysis was performed on 45 closed calcaneal fractures treated in the Department of Orthopedics,the Second Hos-pital of Shanxi Medical University from December 2020 to December 2022.The patients were divided into observation group(n=22)and control group(n=23)according to whether tranexamic acid was used.In the observation group,100 mL sodium chlo-ride+1 g tranexamic acid was injected intravenously before surgery,tranexamic acid dilution was applied to the broken end dur-ing fluoroscopy and after irrigation,and 20 mL tranexamic acid dilution was injected along the drainage tube after suture.In the control group,100 mL sodium chloride was injected intravenously before surgery,sodium chloride was applied to the broken end of the fracture during intraoperative fluoroscopy,and 20 mL sodium chloride was injected along the drainage tube after su-ture.The drainage rate within 24 h,the difference of hemoglobin before and after operation,postoperative incision complications and deep venous thrombosis of lower limbs were recorded in the two groups for 3 consecutive days after operation.Results All patients were followed up.The observation group was followed up for 3-12 months,with an average of 7.69 months.The control group was followed up for 3 to 15 months,with an average of 8.09 months.Blackened incisions occurred in 5 cases in the obser-vation group and 3 cases in the control group.The incisions healed after active non-surgical treatment.No deep venous thrombo-sis occurred in both groups.The hemoglobin of observation group was higher than that of control group after operation,and the difference of hemoglobin before and after operation was smaller than that of control group,with statistical significance(P<0.05).The drainage volume of the observation group was significantly lower than that of the control group on the first and second day af-ter surgery,with statistical significance(P<0.05),but there

关 键 词：跟骨骨折 氨甲环酸 出血量 

分 类 号：R683.4[医药卫生—骨科学]