全膝关节置换术中局部应用氨甲环酸对术后失血量的影响

The effect of topical administration of tranexamic acid on blood loss following total knee arthroplasty

目的探讨全膝关节置换术(TKA)中局部应用氨甲环酸(TXA)对术后失血量的影响。方法选取2013年10月至2016年6月于本院首次接受TKA治疗的患者56例,按年龄、性别等因素匹配后设置为观察组和对照组,每组28例。对照组术中未使用任何止血药物,而观察组术中局部应用TXA溶液冲洗手术创腔。分别统计两组患者的术中失血量、术后48小时引流量、术后48小时血红蛋白水平、输血患者比例以及并发症发生率,并进行组间比较。结果两组患者的术中失血量差异无显著性。观察组术后48小时引流量明显低于对照组,血红蛋白水平明显高于对照组,输血患者比例明显低于对照组,差异有显著性(P<0.05)。两组术后并发症发生率差异无显著性(P>0.05)。结论 TKA术中局部应用TXA能在一定程度上减少术后失血量。

objective To explore the effect of topical administration of tranexamic acid （TXA） on blood loss following total knee arthroplasty. Method Patients who received primary TKA at our institution from October 2013 to June 2016 were grouped as control and study group, respectively. And there were 28 patients who were matched by age and sex were enrolled in each group. Control cases received no intra-operative hemostatics, while patients of the study group were treated with topical TXA after the implantation of knee prostheses. Intra-operative blood loss, postoperative drainage, postoperative hemoglobin levels, and transfusion rates were calculated and were compared between the two groups. Result No significant difference was found for intra-operative blood loss between the two groups. There was significant difference between the two groups in postoperative drainage volume and hemoglobin （P〈0.05）. Conclusion Local application of TXA in total knee arthroplasty can reduce postoperative blood loss.