静脉联合局部应用氨甲环酸在全髋关节置换术的止血效果

Hemostasis Effect of Intravenous Injection Combined with Topical Tranexamicacid for Total Hip Arthroplasty

目的评价全髋关节置换术(THA)中静脉联合局部应用氨甲环酸(TXA)减少THA失血的有效性和安全性。方法回顾性分析2016年9月至2017年5月因骨骰头缺血性坏死(ONFH)及OA在郑州大学人民医院骨科接受THA手术治疗的106例患者的临床资料,根据围手术期氨甲环酸的使用方法不同分为两组。对照组为单纯静脉应用TXA者(50例),实验组为静脉联合局部应用TXA者(56例)。通过观察两组患者的总失血量、术后引流量、输血率、血栓发生率来评价其疗效。结果实验组患者的总失血量为(791.32±197.32)mL,术后引流量为(162.41±36.54)mL,输血率为1.8%均明显低于对照组(P<0.05)。所有患者均无下肢深静脉血栓形成及肺栓塞。结论与单纯静脉应用TXA相比,静脉联合局部应用TXA在减少出血量、术后引流量和输血率方面具有突出的优势,且不会增加下肢深静脉血栓形成的机率,具有良好的安全性和有效性。

Objective To evaluate the efficacy and safety of intravenous injection combined with topical tranexamicacid(TXA)for reducing bleeding during total hip arthroplasty(THA). Methods We retrospectively analyzed the clinical data of 106 patients who underwent THA surgery on the basis of ONFH and OA in Orthopaedics of People's Hospital of Zhengzhou University from September 2016 to May 2017,and were divided into 2 groups based on the different use methods of TXA in perioperative. The control group was intravenous administration of TXA alone(50 patients)and the experimental group were intravenous injection combined with topical TXA(56 patients). Total blood loss,postoperative draining and transfusion rate were recorded to evaluate the efficacy. Results In the experimental group,total blood loss was(791.32±197.32)mL,postoperative draining was(162.41±36.54)mL ml and transfusion rate was 1.8%,which were significantly lower than those in the control group(P<0.05). All patients had no deep vein thrombosis and pulmonary embolism. Conclusion Compared with intravenous TXA alone,intravenous injection combined with topical TXA has outstanding advantages in reducing bleeding,postoperative draining,and transfusion rate,and does not increase the chance of deep vein thrombosis.