氨甲环酸对单侧全髋关节置换术失血影响及安全性

EFFECT AND SAFETY OF TRANEXAMIC ACID ON PERIOPERATIVE BLOOD LOSS IN UNILATERAL TOTAL HIP REPLACEMENT

目的探讨氨甲环酸对首次单侧全髋关节置换术失血的影响及其安全性。方法 2011年10月—2012年6月,选取本院收治的诊断为单侧股骨头坏死并拟行初次单侧全髋关节置换术病人60例,随机分为2组,各30例。皮肤缝合完毕,对照组给予50g/L葡萄糖注射液100mL静滴;实验组将1g氨甲环酸溶于50g/L葡萄糖注射液100mL中静滴。比较两组总失血量、术中出血量、术后引流血量、隐性失血量、凝血酶原时间（PT）、PT比值和活化部分凝血酶时间（APTT）。结果两组总失血量、术后引流血量、隐性失血量差异有统计学意义（t=2.171～2.508,P〈0.05）,术中出血量及术后PT、PT比值、APTT比较差异均无显著性（P〉0.05）。结论氨甲环酸能明显减少单侧全髋关节置换术的总失血量及隐性失血量,同时并不增加血栓形成风险。

Objective To investigate the effect and safety of tranexamic acid on perioperative blood loss in primary unilateral total hip replacement（THR）. Methods During Oct.2011—Jun.2012,60patients diagnosed with unilateral femoral head necrosis scheduled for THR were enrolled and equally randomized to two groups.Upon completion of skin closure,the patients in the control group were given I.V.drip of 100mL of 50g/L glucose solution,those in the experimental group were given I.V.drip of 1g of tranexamie acid with 100mL of 50g/L glucose solution.A comparison was made between the two groups in terms of total blood loss,intraoperative blood loss,postoperative blood drainage,hidden blood loss,prothrombin time（PT）,PTinr and APTT. Results The differences of total blood loss,postoperative blood drainage volume and hidden blood loss between the two groups were significant（t=2.171-2.508,P〈0.05）,that of intraoperative blood loss,and postoperative PT,PT-inr and APTT were not statistically significant（P〈0.05）. Conclusion Tranexamic acid can obviously reduce both total and hidden blood loss in unilateral total hip replacement,and does not increase the risk of thrombosis.