摘要
目的：通过分组对照实验，探讨氨甲环酸的不同使用方式对全髋关节置换术（THA）显隐性失血的影响。方法病例选自该院骨科2010年3月至2013年8月共60例患者。诊断：股骨颈骨折47例，股骨头坏死13例；年龄45～82岁，平均62岁，均接受单侧T H A。所有病例分为A组、B组和C组共3组，各20例，经过筛选，每组男性6例，女性14例，均为初次全髋置换。A组术前0．5 h、术后3 h分别予100 mL生理盐水静滴；B组术前0．5 h将氨甲环酸按10 mg／kg稀释于100 mL生理盐水中静滴，术后3 h予100 mL生理盐水静滴；C组术前0．5 h、术后3 h分别将氨甲环酸按10 mg／kg稀释于100 mL生理盐水中静滴。计算各组患者的显性及隐性失血量，并进行统计学分析，探讨实验组中氨甲环酸2种使用方式的有效性及安全性。结果显性红细胞丢失量：A组（196．20±44．45）m L ，B组（114．84±35．21）m L ，C组（104．47±30．01）m L ；隐性红细胞丢失量：A组（614．50±98．41）m L ，B组（425．74±70．01）m L ，C组（337．12±52．23）m L。结论氨甲环酸的使用能明显减少T H A的显隐性失血量，术前0．5h合并术后3h使用较术前0．5h使用对减少隐性失血量效果更佳，进一步减少输血量，且不会明显增加下肢深静脉血栓形成的发生率。
Objective To explore the influence of tranexamic acid used in different modes in total hip arthroplasty （T HA ） blood loss by control experiment .Methods 60 patients accepted total hip arthroplasty from orthopaedics in our hospital were se‐lected between March 2010 to August 2013 ,among them femoral neck fracture were 47 cases and 13 cases were osteonecrosis .aged between 45‐82 years old ,and 62 in average .All gave unilateral total hip arthroplasty .All patients were divided into three groups ,A group（contradistinction group） ,B ,C group（experiment group） .each groups include 6 men and 14 women ,no revision surgery pa‐tients .For group A ,100 mL normal saline was dripped both in half on hour before surgery and 3 hours after surgery ;For group B , tranexamic acid diluted in 100 mL normal saline according to 10 mg/kg was dripped half on hour before surgery ,100 mL normal sa‐line was dripped 3 hour after surgery ;For group C ,tranexamic acid diluted in 100 mL normal saline according to 10 mg/kg was dripped both half on hour before surgery and 3 hour after surgery .Compute and record the visible blood cell loss and hidden blood loss ,the comparative analysis was conducted to discuss the effectiveness and safety of tranexamic acid used in the two methods .Re‐sults The visible blood cell loss in each group were （196 .20 ± 44 .45）mL ,（114 .84 ± 35 .21）mL and （104 .47 ± 30 .01）mL ;hidden blood loss in each group were：（614 .50 ± 98 .41）mL ,（425 .74 ± 70 .01）mL and （337 .12 ± 52 .23）mL .Conclusion In the unilateral total hip arthroplasty ,the use of tranexamic acid can significantly reduce a significant amount of visible and hidden blood loss .Com‐pared with tranexamic acid dripped just half one hour before surgery ,dripping tranexamic acid both half one hour before surgery and 3 hour after surgery reduced more hidden blood loss ,decreased transfusion requirement ,and this does not significantly increase the risk of deep venous thrombosis .
出处
《重庆医学》
CAS
北大核心
2015年第8期1063-1065,1068,共4页
Chongqing medicine
关键词
氨甲环酸
髋关节置换
隐性失血
tranexamic acid
total hip arthroplasty
hidden blood loss
