氨甲环酸对手部骨折术后凝血功能及手部功能的影响  

Effect of tranexamic acid on coagulation and hand function after surgery for hand fracture

作　　者：宋春林[1] 罗成军[2] 朱雨 Song Chun-lin;Luo Cheng-jun;Zhu Yu(Department of Orthopedics,People’s Hospital of Leshan,Leshan 614000,China;Department of Neurosurgery,People’s Hospital of Leshan,Leshan 614000,China;Department of Ophthalmology,People’s Hospital of Leshan,Leshan 614000,China)

机构地区：[1]乐山市人民医院骨科,乐山614000 [2]乐山市人民医院神经外科,乐山614000 [3]乐山市人民医院眼科,乐山614000

出　　处：《中国药物应用与监测》2024年第3期276-279,共4页Chinese Journal of Drug Application and Monitoring

基　　金：四川省医学会骨科(尚安通)专项科研课题(2020SAT11)。

摘　　要：目的探究氨甲环酸对手部骨折术后凝血功能及手部功能的影响。方法选取2021年5月至2023年7月于乐山市人民医院行手部骨折术的64例手部骨折患者,采取抽签法将其随机分为观察组(n=32)和对照组(n=32),对照组患者在术前30 min予以100 mL氯化钠注射液静脉滴注,观察组患者术前30 min静脉滴注100 mL氯化钠注射液+氨甲环酸注射液,对比两组患者的总失血量、凝血功能、手部功能及不良反应情况。结果观察组围手术期总失血量(57.39±9.68)mL与对照组(103.28±14.97)mL比较差异有统计学意义(P<0.05)。在活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)浓度水平方面,手术前后两组患者对比差异无统计学意义(P>0.05)。观察组与对照组治疗前后的徒手肌力评定量表(MMT)评分差值[分别为(1.57±0.19)、(2.14±0.22)分]、Fugl-Meyer手运动功能评分(FMA)差值[分别为(4.28±1.06)、(5.37±1.27)分]差异有统计学意义(t=11.092,P<0.05;t=3.727,P<0.05)。在不良反应总发生率方面,对照组(3.13%)低于观察组(6.25%),但两组数据差异无统计学意义(P>0.05)。结论术前应用氨甲环酸可以有效减少手部骨折术患者围手术期出血量,且不会对患者的凝血功能造成较大的影响,且有助于术后手部功能的恢复。Objective To investigate the effect of tranexamic acid on coagulation and hand function after hand fracture surgery.Methods Sixty-four patients undergoing hand fracture surgery in People’s Hospital of Leshan from May 2021 to July 2023 were selected,and randomly grouped using lottery method,with 32 in each group.The patients in the control group were given intravenous drip of 100 mL sodium chloride 30 min before operation,and those in the observation one intravenous injection of 100 mL of sodium chloride+tranexamic acid 30 min before operation.The total blood loss,coagulation function,hand function and adverse reactions were compared between the 2 groups.Results Perioperative total blood loss was(57.39±9.68)mL in the observation group and(103.28±14.97)mL in the control,showing statistical difference(P<0.05).There was no statistical difference in prothrombin time(PT),activated partial thromboplastin time(APTT),and D-dimer(D-D)at baseline between the 2 groups before and after operation(P>0.05).The differences in pre-and post-treament manual muscle testing(MMT)((1.57±0.19),(2.14±0.22)scores,separately)and Fugl-Meyer assessment(FMA)((4.28±1.06),(5.37±1.27)scores,separately)demonstrated statistical difference between the two groups(t=11.092,P<0.05;t=3.727,P<0.05).The total adverse reaction rate was 3.13%in the control group,which was slightly lower than 6.25%of the observation group,demonstrating no statistical difference(P>0.05).Conclusion Preoperative application of tranexamic acid can effectively reduce perioperative blood loss in patients undergoing hand fracture surgery without affecting coagulation function.Meanwhile,it can promote the recovery of hand function after surgery.

关 键 词：手部骨折术 氨甲环酸 凝血功能 手部功能 失血量 

分 类 号：R969.3[医药卫生—药理学]