[1]陆华,孙美煜,顾荣胜,等.局部应用不同剂型氨甲环酸对全髋关节置换术后失血量的影响[J].中国中医骨伤科杂志,2019,27(05):40-43.
　LU Hua,SUN Meiyu,GU Rongsheng,et al.Effect of Topical Application of Different Forms of Tranexamic Acid on Blood Loss after Total Hip Arthroplasty[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(05):40-43.
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局部应用不同剂型氨甲环酸对全髋关节置换术后失血量的影响()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年05期
页码:
40-43
栏目:
临床论著
出版日期:
2019-05-15

文章信息/Info

Title:
Effect of Topical Application of Different Forms of Tranexamic Acid on Blood Loss after Total Hip Arthroplasty
文章编号:
1005-0205(2019)05-0040-04
作者:
陆华1; 孙美煜1; 顾荣胜1; 祁兆健1; 孟庆国1; 韩廷成1; 陈大志1; 范广峰1; 田敏1△; 
1南京中医药大学附属盐城市中医院(江苏 盐城,224001)
Author(s):
LU Hua1; SUN Meiyu1; GU Rongsheng1; QI Zhaojian1; MENG Qingguo1;  HAN Tingcheng1; CHEN Dazhi1; FAN Guangfeng1; TIAN Min1△
1Department of Orthopaedics,Yancheng Hospital of Traditional Chinese Medicine,Yancheng 224001,Jiangsu China.
关键词:
氨甲环酸;  全髋关节置换术;  关节腔内给药;  粉剂与针剂
Keywords:
tranexamic acid;  total hip arthroplasty;  intra-articular administration;  powder and injection
分类号:
R684
文献标志码:
A
摘要:
目的:观察不同剂型氨甲环酸对老年股骨颈骨折全髋关节置换术后失血量的影响。方法:选取本院自 2016年1月至2018年1月因新鲜股骨颈骨折行全髋关节置换术的患者为研究对象,根据术中切口内使用氨甲环酸剂型不同分A组(氨甲环酸粉剂3 g)和B组(氨甲环酸针剂3 g,50 mL)。研究对比两组总失血量、术后引流量、隐性失血量、凝血指标、术后3个月,6个月及12个月髋关节Harris评分及并发症。结果:术前两组患者性别、年龄、体质量指数(BMI值)、血红蛋白(Hb)及红细胞压积(Hct)、活血部分凝血酶时间(APTT)差异无统计学意义(P>0.05)。全髋关节置换术后总失血量、术后引流量及隐性失血量A组均大于B组,差异有统计学意义(P<0.05),两组术后国际标准化比值(INR)、凝血酶原时间(PT)、活血部分凝血酶时间(APTT)及术后3个月,6个月及12个月髋关节Harris功能评分比较差异无统计学意义(P>0.05)。结论:全髋关节置换术后关节腔内氨甲环酸使用针剂对减少术后总失血量、术后引流量及隐性失血量优于粉剂,两者均安全有效,不增加下肢深静脉血栓(DVT)、肺栓塞(PE)发生率及感染风险,两者对髋关节功能影响无差异。
Abstract:
Objective:To observe the efficacy and safety of different formulation forms of tranexamic acid for recessive blood loss after total hip arthroplasty for femoral neck fracture in the elderly.Methods:60 cases of patients undergoing total hip arthroplasty for fresh femoral neck fractures in our hospital between January 2016 to January 2018 were selected as the study objects. According to the use of tranexamic acid dosage form in the incision, the study objects were randomly divided into two groups: group A(Tranexamic acid powder 3 g), group B(Tranexamic acid injection 3 g,50 mL). Comparison were made on the postoperative drainage, total red blood cell loss, cryptic red blood cell loss, coagulation parameters, hip harris score and complications in 3 months, 6 months, 12 months after operation in two groups. Results:There were no significant differences in gender, age, BMI, HB and HTC, and coagulation parameters between the two groups before surgery.Postoperative drainage, total red blood cell loss and recessive red blood cell loss were higher in group A than in group B,The difference was statistically significant(P<0.05). There were no significant differences in postoperative INR, PT, APTT and hip function scores in 3 months, 6 months, 12 months after operation(P>0.05).Conclusion:Intra-articular injection of tranexamic acid after total hip arthroplasty is effective in reducing postoperative drainage, total red blood cell loss, and recessive red blood cell loss. Both are safe and effective, and do not increase the incidence of DVT. Risk of infection, no difference in hip function.

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备注/Memo

备注/Memo:
△通信作者 E-mail:ycszyy862@163.com
更新日期/Last Update: 2019-05-15