静脉注射联合关节腔灌注氨甲环酸对肩关节镜肩袖修补术后患者的作用效果  

Effect of Intravenous Injection Combined with Joint Tranexamic Acid Infusion in Patients After Shoulder Arthroscopic Rotator Cuff Repair

作　　者：邢林卿[1] 胡明鑫 董永浩 王勇[1] 张保龙[1] 尤笑迎[1] 尹万乐[1] XING Linqing;HU Mingxin;DONG Yonghao;WANG Yong;ZHANG Baolong;YOU Xiaoying;YIN Wanle(Department of Third Orthopedics,Zhengzhou People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州人民医院骨三科,河南郑州450000

出　　处：《河南医学研究》2024年第12期2180-2184,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200677)。

摘　　要：目的 探究静脉注射联合关节腔灌注氨甲环酸对肩关节镜肩袖修补术后患者的影响。方法 收集医院2020年2月至2022年11月收治的84例接受肩关节镜肩袖修补术患者的临床资料。依照术中止血干预方式分为观察组(56例,静脉注射联合关节腔灌注氨甲环酸)和对照组(28例,氨甲环酸静脉注射)。比较两组血红蛋白、手术出血量、手术时间、肩关节肿胀情况、疼痛程度、肩关节功能、并发症、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-3(MMP-3)水平。结果 术后1 d两组血红蛋白下降,观察组高于对照组(P<0.001)。两组手术出血量、手术时间相比,差异有统计学意义(P<0.001)。两组肩关节周径组间、时间、交互效应有统计学意义(P<0.05)。术后1、2 d,两组疼痛评分差异有统计学意义,且观察组低于对照组(P<0.05);两组术后2 d的疼痛评分均低于术后1 d(P<0.001)。术后1个月两组肩关节功能评分均高于术前,观察组高于对照组(P<0.001)。两组术后IL-1β、TNF-α、MMP-3均降低,且观察组低于对照组(P<0.001)。结论 静脉注射联合关节腔灌注氨甲环酸应用于肩关节镜肩袖修补手术中能够有效发挥止血作用,减轻炎症反应,缓解患者疼痛,改善肩关节功能,相对安全。Objective To explore the effect of intravenous injection combined with tranexamic acid infusion in patients after shoulder arthroscopic rotator cuff repair.Methods Clinical data were gathered on 84 patients who underwent shoulder arthroscopic rotator cuff repair at the hospital from February 2020 to November 2022.According to the intraoperative hemostasis intervention method,they were divided into an observation group(56 cases,intravenous injection combined with intra-articular infusion of tranexamic acid)and a control group(28 cases,intravenous injection of tranexamic acid).The levels of hemoglobin,surgical bleeding,surgical time,shoulder joint swelling,pain level,shoulder joint function,complications,interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and matrix metalloproteinase-3(MMP-3)between two groups were compared.Results One day after surgery,the hemoglobin levels in both groups decreased,and the observation group was higher than the control group(P<0.001).There was a statistically significant difference in the amount of surgical bleeding and surgical time between the two groups(P<0.001).The inter group,time and interaction effects of shoulder joint circumference between the two groups were statistically significant(P<0.05).On postoperative day 1 and 2,there was a statistically significant difference in pain scores between the two groups,and the observation group was lower than the control group(P<0.05).The pain scores of both groups at 2 days postoperatively were lower than those at 1 day postoperatively(P<0.001).One month after surgery,the shoulder joint function scores of both groups were higher than before surgery,and the observation group was higher than the control group(P<0.001).After surgery,IL-1β,TNF-αand MMP-3 levels decreased in both groups,and the observation group were lower than the control group(P<0.001).Conclusion The application of intravenous injection combined with articular tranatemic acid in shoulder arthroscopic rotator cuff repair surgery can effectively play a hemostatic rol

关 键 词：氨甲环酸 肩关节镜 肩袖修补手术 止血 炎症 疼痛 

分 类 号：R684.3[医药卫生—骨科学]