氨甲苯酸在肩胛带骨折手术出血控制中的应用分析  

Application analysis of aminomethylbenzoic acid in bleeding control of shoulder girdle fracture surgery

作　　者：袁亚兵[1] 李冰[1] 徐鹏[1] 钱志鹏 YUAN Yabing;LI Bing;XU Peng(Bone trauma Department,Changzhou Wujin Hospital of Traditional Chinese Medicine,Changzhou 213161,China;不详)

机构地区：[1]常州市武进中医医院骨伤一科,江苏常州213161 [2]常州市武进中医医院骨外科,江苏常州213161

出　　处：《中国处方药》2025年第6期75-78,共4页Journal of China Prescription Drug

基　　金：2023年度常州市卫健委科技项目(WZ202310)。

摘　　要：目的探讨氨甲苯酸在肩胛带骨折手术出血控制中的应用效果。方法纳入2022年9月~2024年9月期间于常州市武进中医医院就诊的89例肩胛带骨折手术患者,采用随机数字表法将其分为对照组(45例)、氨甲苯酸组(44例)。两组均接受手术治疗,氨甲苯酸组在手术切皮前0.5 h将0.5 g氨甲苯酸稀释于50 ml生理盐水后行静脉滴注,对照组给予等量生理盐水静脉滴注。比较两组出血控制效果[总失血量(TBL)、术中显性失血量(VBL)、隐性失血量(HBL)、异体输血量],术后24 h、72 h血常规检测指标[血红蛋白浓度(Hb)、红细胞压积(HCT)、血小板计数(PLT)]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)、纤维蛋白原(FIB)],术后3个月肩关节功能恢复效果[美国肩肘外科协会评分(ASES)、Constant-Murley肩关节功能量表(CMS)评分]以及并发症发生情况。结果氨甲苯酸组TBL、VBL、HBL、异体输血量均低于对照组(P<0.05);术后72 h,两组Hb、HCT、PLT均降低(P<0.05),但氨甲苯酸组均高于对照组(P<0.05);术后72 h,两组FIB、D-D均升高(P<0.05),但氨甲苯酸组均低于对照组(P<0.05);术后3个月,氨甲苯酸组ASES、CMS各维度评分均高于对照组(P<0.05);两组总并发症发生率比较(13.33%vs.6.82%),差异无统计学意义(P>0.05)。结论肩胛带骨折手术中应用氨甲苯酸,可显著减少患者围手术期失血、输血量,增强血液保护作用,加速术后肩胛关节功能的康复,且并未增加血栓性并发症风险。Objective To explore the application effect of aminomethylbenzoic acid in the bleeding control of shoulder girdle fracture surgery.Methods A total of 89 patients with shoulder girdle fracture surgery in Changzhou Wujin Hospital of Traditional Chinese Medicine from September 2022 to September 2024 were included and divided into the control group(45 cases)and the aminomethylbenzoic acid group(44 cases)by random number table method.Both groups received surgical treatment,and the aminomethylbenzoic acid group was given intravenous drip of 0.5 g of aminomethylbenzoic acid diluted in 50 ml of normal saline 0.5 hours before surgical incision,while the control group was given intravenous drip of the same amount of normal saline.The bleeding control effects[total blood loss(TBL),visible blood loss(VBL),hidden blood loss(HBL),allogeneic blood transfusion volume],blood routine test indicators[hemoglobin concentration(Hb),hematocrit value(HCT),platelet count(PLT)]and coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D),fibrinogen(FIB)]at 24 hours and 72 hours after surgery,shoulder function recovery effects[American Shoulder and Elbow Surgeons(ASES)score,Constant-Murley Scale(CMS)]at 3 months after surgery and occurrence of complications were compared between the two groups.Results TBL,VBL,HBL and allogeneic blood transfusion volume in the aminomethylbenzoic acid group were lower than those in the control group(P<0.05).At 72 hours after surgery,Hb,HCT and PLT levels in both groups were decreased(P<0.05),but the levels were higher in the aminomethylbenzoic acid group than those in the control group(P<0.05).The FIB and D-D levels in the two groups were increased at 72 hours after surgery(P<0.05),but the levels in the aminomethylbenzoic acid group were lower than those in the control group(P<0.05).The score of dimensions of ASES and CMS in the aminomethylbenzoic acid group at 3 months after surgery were higher than those in the control group(P<0.05).There was no statistic

关 键 词：肩胛带骨折 氨甲苯酸 出血控制效果 凝血指标 

分 类 号：R68[医药卫生—骨科学]