氨甲环酸对膝关节置换术后失血的影响

Effect of Tranexamic Acid on the Hemorrhage after Knee Arthroplasty

目的探讨氨甲环酸术前静脉给药及关节腔周围注射对膝关节置换术后失血的影响。方法 2014年1月—2015年6月,该院骨一科共74例关节置换的患者,随机分成两组,治疗组及对照组各37例,观察两组术后失血量,是否出现下肢深静脉血栓,术后3 h D-二聚体、纤维蛋白原、活化的部分凝血酶时间。结果治疗组与观察组术后失血量分别为(483.62±157.54)m L与(1 257.46±226.86)m L,差异有统计学意义(P<0.05),术后下肢深静脉发生率、D-二聚体、FIB、APTT比较差异无统计学意义(P>0.05)。结论氨甲环酸术前静脉给药及关节周围注射能显著减少膝关节置换术后失血,且不增加下肢深静脉血栓的发生。

Objective To study the effect of tranexamic acid on the hemorrhage after Knee arthroplasty. Methods 74 cases of patients with joint replacement in the first department of orthopedics in our hospital from January 2014 to June 2015 were selected and randomly divided into two groups with 37 cases in each, and the postoperative blood loss, whether the deep vein thrombosis occurred or not, 3 h D-dimer after operation, contractinogen and activated partial thromboplastin time of the two groups were observed. Results The postoperative blood loss in the treatment group and the observation group were respective（483.62±157.54）m L and（1 257.46±226.86）m L（P0.05）, and the difference had statistical significance（P0.05）, and the differences in the incidence rate of deep veins of lower limb after operation, D-dimer, FIB and APTT had no statistical significance（P0.05）. Conclusion The vein administration before the tranexamic acid operation and joint peripheral injection can obviously reduce the hemorrhage after Knee arthroplasty and not increase the occurrence of the deep vein thrombosis.