氨甲环酸在全髋关节置换术中局部应用的安全性和有效性研究

目的探讨氨甲环酸在单侧全髋关节置换术中局部应用的安全性和有效性.方法 82例单侧股骨颈骨折需行全髋关节置换术的患者被随机分成2组.A组41例,准备缝合切口前予以1.0 g氨甲环酸10 m L溶液均匀注入关节腔内,术后2 h后开始开放引流管;B组41例,不使用氨甲环酸,仅予以10 m L盐水注射关节腔内.分别计算各组的总失血量、隐性失血量、术后血红蛋白、术后红细胞压积、输血量与输血患者下肢出现深静脉血栓临床症状的例数,术前及术后4 h检查血凝常规,并对上述数据进行相应分析.结果 A组与B组总失血量、隐性失血量、输血量、输血人数比较差异具有统计学意义(P0.05),A组均低于B组;血凝常规比较差异无统计学意义(P0.05),两组均未见深静脉血栓形成.结论氨甲环酸术区局部应用可明显减少行单侧全髋关节置换术的失血量,是一种安全和有效的方法.

On Safety and Efficiency of Topical Application of Tranexamic Acid in Total Hip Replacement

Objective To explore the safety and efficiency of topical application of tranexamic acid in unilateral total hip replacement. Method A total of 82 patients who received primary unilateral total hip arthroplasty due to femoral neck fracture were randomly divided into two groups. The patients in the experimental group( group A, n=41 ) were injected 1 . 0 g tranexamic acid within 10 mL normal saline into their articular cavity before suturing the incisions. The control group(group B,n=41) were only injected 10 mL normal saline. The drainage tubes of the patients in the two groups were opened 2 hours later. Then,postoperative blood loss,hidden blood loss,the number of hemoglobin and hematocrit,the number of patients accepted blood transfusion and the blood volume were detected and compared. Clinical symptoms such as pulmonary embolism( PE) and lower extremity deep vein thrombosis(DVT) were also observed. Hemagglutination inspection was operated at the 4th hour before and after the surgery. All above data were recorded and analyzed. Results The amounts of blood loss,hidden blood loss, the number of blood transfusion and blood transfusion volume were much lower,while the values of postoperative hemoglobin and hematocrit were significantly higher in the experimental group compared with those in the control group ( P<0 . 05 ) . There was no significant difference in the results of hemagglutination inspection between the two groups(P>0. 05). And no deep venous thrombosis was observed through doppler ultrasound examination. Conclusion The topical application of tranexamic acid in the aged receiving THA could significantly decrease the amount of blood loss and blood transfusion,which is an efficient and safe way to reduce blood loss.