术中关节腔内注射氨甲环酸对人工膝关节置换术围术期失血量的影响

Influence of intra-articular injection of intraoperative tranexamic acid on perioperative blood loss of artificial knee joint replacement

目的评价术中关节腔内注射氨甲环酸对于人工膝关节置换术围术期失血量的影响。方法采用单中心、随机、对照、前瞻性研究,将2009年1月—2011年1月符合准入标准的83例行人工膝关节置换的病例,按随机数字表法随机分为氨甲环酸组(A组)40例及对照组(B组)43例,观察记录两组输血量、失血量、手术时间、术中术后并发症、平均住院日并进行比较。结果随访率100%,失血量、术后输血量A组与B组间比较有统计学差异(P<0.05),其余各项指标均无统计学差异。结论人工关节置换术中应用氨甲环酸可以减少失血量及输血量,并且安全有效,未增加下肢深静脉血栓形成等危险。

Objective To evaluate the influence of intra-articular injection of intraoperative tranexamic acid on perioperative blood loss of artificial knee joint replacement. Methods We adopted a single-center, prospective, randomized, controlled study on 83 cases performed artificial knee joint replacement that met the criteria between Jan 2009 to Jan 2011. According to random number table method all the cases were randomly assigned to tranexamic acid group （Group A, n = 40） and control group （Group B, n = 43）. Blood transfusion, blood loss, operative time, intraoperative complications and hospitalization duration were compared be- tween the two groups. Results The follow-up rate was 100%. The amount of blood loss and postoperative blood transfusion of Group A was significantly different from that of Group B （ P 〈 0.05 ） , and the rest of the indicators were of no statistically significant difference. Conclusion Application of tranexamic acid to artificial joint replacement helps to decrease the volumes of blood loss and blood transfusion without an increase in risk of deep vein thrombosis in lower extremity, and is safe and effective.