摘要
目的:观察术前静脉应用氨甲环酸减少初次全膝关节置换术后对失血量的影响。资料与方法:采用前瞻性的随机对照研究方法,将我科2011年1月-2014年10月收治的100例拟行单侧TKA手术的患者按查随机数字表法进行随机分组,分为实验组和对照组,每组50例。实验组术中在手术开始前30分钟静脉输入氨甲环酸(15mg/kg,最大剂量不超过1.2g);对照组术中不使用氨甲环酸。两组患者术后对比引流量、血红蛋白、总失血量、总输血量、凝血酶原时间、活化部分凝血活酶时间、D-二聚体、以及术后DVT的发生率。结果:术前两组患者一般情况无统计学差异(P>0.05),实验组术后引流量、总失血量、总输血量明显低于对照组(P<0.05),血红蛋白量均高于对照组(P<0.05),两组患者术后凝血酶原时间、活化部分凝血活酶时间、D-二聚体、以及术后DVT的发生率比较无统计学差异(P>0.05)。结论:采用术前静脉输入氨甲环酸可明显的减少全膝关节置换术后出血,减少患者输血量,且并无增加患者DVT的风险。
Objective：To investigate the effect of preoperative intravenous application of tranexamic acid on blood loss after total Knee arthroplasty. Methods ： From Jan 2011 to Aug 2014,we choose 100 patients who received unilateral total knee arthroplasty were randomly divided into two groups. In experimental group, 50 patients used intravenous infusion of tranexamic acid 30 minutes prior to the operation. In controlled group,we did not use tranexamic acid. Comparison of two groups included dainage volume, hemoglobin, total blood loss, total volume of blood transfusion, prothrombin time（PT）, activated partial thromboplastin time（APTT）, D--dimer,the incidence of postoperative DVT.Result： Patients with tranexamic acid had a significantly lowerdainage volume, total blood loss and volume of blood transfusion （p〈0.05） compared to those who underwent a conventional TKA.There were no significant difference in prothrombin time（PT）, activated partial thromboplastin time（APTT） and D--dimer,the incidence of postoperative DVT （p〉0.05）.Conclusion; With intravenous application of tranexamic acid,the blood loss and volume of blood transfusion can be significantly decreased and also did not increase the risk of DVT.
