氨甲环酸序贯抗凝药对膝关节置换术失血量的临床研究

Clinical study of tranexamic acid sequential anticoagulant drugs on blood loss of knee arthroplasty

目的:探讨氨甲环酸序贯应用抗凝药对全膝关节置换术失血量和输血率的影响。方法:收治行全膝关节置换术的骨性关节炎患者60例(60膝),随机分为试验组和对照组。试验组采用氨甲环酸,对照组不采用氨甲环酸,比较两组治疗效果。结果:试验组的术后显性失血量、术后隐性失血量、输血量、输血率均优于对照组(P<0.05)。两组术后出现血栓事件差异无统计学意义(P>0.05)。结论:行全膝关节置换术的膝骨关节炎患者行氨甲环酸静脉联合局部治疗,序贯应用抗凝药物,术后出血量及术后引流量减少,输血量明显减少,输血率降低,减少了患者发生输血风险及相关并发症,保障患者平稳度过围手术期,为患者节省医疗费用,为国家节省输血相关的医疗资源与费用,利国利民。

Objective：To explore the influence of tranexamic acid sequential anticoagulant drugs on blood loss and transfusion rate of knee arthroplasty.Methods：60 patients（60 knees） with osteoarthritis treated with knee arthroplasty were selected.They were randomly divided into the experimental group and the control group.The experimental group was treated with tranexamic acid,and the control group was treated without tranexamic acid.We compared the therapeutic effect of two groups.Results：In the experimental group,the postoperative dominant blood loss,postoperative occult blood loss, blood transfusion,blood transfusion rate were lower than those of the control group（P〈0.05）.There was no significant difference in the incidence of postoperative thrombotic events between groups（P〈0.05）.Conclusion：The application of combined intravenous and topical treatment of tranexamic acid with sequential application of anticoagulant drugs for patients with osteoarthritis treated with knee arthroplasty can reduce postoperative bleeding volume,postoperative drainage volume,blood transfusion volume,blood transfusion rate,blood transfusion risk and related complications.It can protect the patients smoothly through perioperative period,save medical expense for patients,save medical resources and costs related to blood transfusion for the country,and it was better for country and people.