氨甲环酸在人工全膝关节置换术中局部应用的疗效观察

Curative efficacy of topical tranexamic acid in total knee arthroplasty

①目的探讨氨甲环酸在全膝关节置换术中局部关节腔内注射对于减少术后出血量及输血量的疗效。②方法选取2014年6月~2016年5月因重度骨关节炎行单侧全膝关节置换术的100例患者为研究对象,其中男42例,女58例,年龄51~70岁,病程3~13年,平均7年。手术均采用髌旁内侧入路。按照治疗方法分成观察组和对照组。观察组采取术中缝合切口后在关节腔内注射50mL氨甲环酸注射液处理;对照组仅注入关节腔内50mL生理盐水。比较两组患者术后引流量、输血量、输血人数及术后第一天血红蛋白、红细胞压积等指标。③结果观察组术后可见出血量、总出血量、输血量、输血人数均少于对照组(P<0.05);术后血红蛋白值和红细胞压积则明显高于对照组(P<0.05)。④结论在全膝关节置换术中局部应用氨甲环酸可明显降低患者失血量及输血量,提高了手术安全性。

Objective To explore the efficacy of intra-articular tranexamic acid injection in reduc- tion of blood loss and blood transfusion in total knee arthroplasty（TKA）. Methods A total of 100 pa- tients hospitalized from June 2014 to May 2016 were selected as research subjects, among whom 42 males and 58 females from 3 to 13 years （an average of 7 years） duration of severe osteoarthritis were treated with unilateral TKA using the Beta parapatellar approach. The patients were randomly divided into 2 groups： observation group were treated with 50mL intra-articular tranexamic acid injection after intraoperative suture of incision, control group received no topical tranexamic acid but 50mL normal saline. Postoperation drainage volume, total drainage volume, blood transfusion, blood transfusion number,postoperative hemoglobin and hematocrit were taken as evaluation indexes to make compari- son between the two groups. Results In comparison to control group,postoperation drainage volume, total drainage volume, blood transfusion and blood transfusion number were significantly decreased （P 〈0.05） ,and in terms of the first postoperative day hemoglobin value and hematocrit（P〈0.05）, it had a significantly increase.Conclusion Topical tranexamic acid in total knee arthroplasty can significantly lower blood loss and blood transfusion in patients,furthermore, also can improve the safety of surgery.