氨甲环酸在髋关节翻修术中应用的研究进展  

Research Progress on the Application of Tranexamic Acid in Revision Hip Arthroplasty

作　　者：伊力夏提·麦麦提艾麦尔 阿斯哈尔江·买买提依明[1] 

机构地区：[1]新疆医科大学第一附属医院关节外科,新疆 乌鲁木齐

出　　处：《临床医学进展》2024年第3期1192-1198,共7页Advances in Clinical Medicine

摘　　要：由于全球预期寿命的增加,关节置换术的总数也有所增加。全髋关节置换术(THA)通常用于髋关节骨关节炎患者,而全髋关节置换术(THA)期间失血量达到1000至1500毫升之间,输血率在21%到70%之间。尽管输血可以挽救生命,但输血与已知的有时会危及生命的不良事件有关。氨甲环酸(TXA)是一种抗纤溶的药物,广泛应用于接受THA的患者。而TXA在THA中的有效性及安全性已被证实,这为骨科医生降低失血量,输血率以及术后并发症更多的髋关节翻修术(RHA)的围手术期失血量及输血率而指了一条明路。本文对以氨甲环酸在全髋关节置换翻修术中的应用进行了综述。首先介绍了TXA的作用机制,包括其抑制纤维蛋白溶解作用和减少纤维蛋白溶酶原激活的能力。随后,回顾了已发布的研究,探讨了TXA在全髋关节置换翻修术中的疗效和安全性。研究结果显示,TXA能够显著减少手术过程中的出血量和输血需求,同时并不增加手术并发症的风险。一些研究还发现,更早地应用TXA可以获得更好的止血效果。综上所述,以氨甲环酸在全髋关节置换翻修术中的应用显示出良好的止血效果和安全性。然而,我们仍然需要进一步的研究,以进一步明确其最佳应用时间和剂量,为临床实践提供更可靠的依据。As global life expectancy rises, so does the number of joint replacement surgeries. Total Hip Arthro-plasty (THA) is commonly performed on patients with hip osteoarthritis, with blood loss during surgery ranging from 1000 to 1500 milliliters and transfusion rates between 21% and 70%. Alt-hough blood transfusions can be lifesaving, they are associated with potentially life-threatening adverse events. Tranexamic Acid (TXA), an antifibrinolytic medication, has been widely used in pa-tients undergoing THA. Its effectiveness and safety in THA have been confirmed, offering orthopedic surgeons a clearer path to reduce blood loss, transfusion rates, and postoperative complications in Revision Hip Arthroplasty (RHA). This article reviews the application of TXA in revision hip arthro-plasty. It first introduces the mechanism of action of TXA, including its ability to inhibit fibrinolysis and reduce the activation of plasminogen to plasmin. Subsequently, it reviews published studies to discuss the efficacy and safety of TXA in hip revision surgeries. The findings indicate that TXA sig-nificantly reduces intraoperative blood loss and the need for blood transfusions without increasing the risk of surgical complications. Some studies have also found that earlier application of TXA can achieve better hemostatic effects. In summary, the application of tranexamic acid in RHA has shown good hemostatic effect and safety. However, further research is still needed to further clarify the op-timal timing and dosage for clinical practice.

关 键 词：髋关节翻修术 氨甲环酸 全髋关节置换术 围手术期出血量 围手术期输血率 

分 类 号：R68[医药卫生—骨科学]