局部使用氨甲环酸联合夹闭引流管6 h减少人工全膝关节置换术后失血量

Influence of tranexamic acid combined with 6 hours clamping of the drainage tube on reduction of blood loss in TKA

目的研究局部使用氨甲环酸联合夹闭引流管6 h是否能减少人工全膝关节置换术后的失血量。方法膝关节骨性关节炎行初次单侧置换的病人60名分成2组。实验组在手术结束后,膝关节腔内注入氨甲环酸并夹闭引流管6 h。对照组在手术结束后,膝关节腔内放置引流管并保持开放状态。观察引流管的引流量,监测手术后红细胞压积、血红蛋白水平并计算出各组总的失血量。结果有4例患者由于各种原因退出了本次研究。实验组的总失血量和引流量均比对照组减少(P<0.05),实验组手术后第7天的血红蛋白水平高于对照组(P<0.05)。结论局部使用氨甲环酸联合夹闭引流管6 h能减少人工全膝关节置换术后的失血量,是一种简便、经济、有效的止血方法。

Objective To explored the influence of tranexamic acid （TA） combined with 6 hours clamping of the drainage tube on reducing blood loss in total knee arthroplasty. Methods 60 patients treated with unilateral primary TKA were divided into two groups. After operation,the patients received TA inside knee joint and clamped the drainage tube for 6 hours （experiment group） , and patients who were not received TA and maintain patency drainage tube after operation （ control group）. The amounts of postoperative drainage, the hematocrit of postoperative, the hemoglobin level at postoperative day （POD） 7 and total blood loss volume were recorded. Results Four patients were withdrawn for various reasons, therefore, fifty - six patients were included in the analysis. Total blood loss and volume of drainage were lower in experiment group than in control group （ P 〈 0. 05 ）. Hemoglobin levels in POD 7 was higher in the study group than that in controls （P 〈 0.05）. Conclusion Postoperative intra - articular injection of TA and 6 hours of drain - clamping can effectively reduce blood loss after TKA. This method is simple, economical and effective for these patients.