局部应用、静脉注射氨甲环酸在全髋关节置换术患者中的应用效果

Effects of Topical and Intravenous Application of Tranexamic Acid in the Total hip Arthroplasty Patients

目的:观察局部应用与静脉注射氨甲环酸(Tranexamic acid,TXA)对全髋关节置换术(Total hip replacement,THA)安全性及减少失血的效果。方法:回顾性分析我院2015年3月—2018年5月56例初次全髋关节置换术患者,按照随机数字表法分为观察组和对照组。对照组不使用氨甲环酸,观察组使用静脉联合局部序贯氨甲环酸,比较两组患者术前血红蛋白(HB)、血细胞比容(HCT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)值,比较术中失血量,术后可见失血量、输血量、输血人数、术后血红蛋白等指标。结果:观察组术中失血量为(210.23±51.01)mL,对照组为(210.44±51.03)mL,两组差异不明显,无统计学意义(P>0.05);观察组术后失血量为(140.56±46.55)mL,输血量为(410.63±26.57)mL,对照组分别为(363.42±51.33)mL、(751.11±49.31)mL,观察组失血量与输血量均低于对照组,差异有统计学意义(P<0.05);观察组输血人数5人,低于对照组的11人,有统计学意义(P<0.05);对照组术后血红蛋白值为(80.61±13.95)g/L,低于观察组(96.88±16.36)g/L,差异有统计学意义(P<0.05)。结论:将氨甲环酸局部应用于全髋关节置换术效果显著,有效降低了患者失血量及输血量,具有临床推广价值。

Objective:To observe the safety and efficacy of topical application and intravenous injection of tranexamic acid(TXA)in total hip arthroplasty(THA).Methods:56cases of primary total hip arthroplasty in our hospital from March2015to May2018were retrospectively analyzed.They were divided into observation group and control group according to random number table.The control group did not use methicatic acid,and the observation group used intravenous combined sequential sequential methicyclic acid.The preoperative hemoglobin(HB),blood cell specific volume(HCT),prothrombin time(PT),and activated partial thromboplastin time(APTT)were compared between the two groups,and the amount of blood loss,blood loss,blood transfusion,transfusion after operation,blood number,postoperative hemoglobin and other indicators were compared.Results:The amount of blood loss in the observation group was(210.23±51.01)mL,the control group was(210.44±51.03)mL,and there was no difference between the two groups(P>0.05).The blood loss of the observation group was(140.56+46.55)mL,the volume of blood transfusion was(410.63±26.57)mL,the control group was(363.42±51.33)mL,(751.11±49.31)mL,therefore,the amount of blood loss in the observation group was significantly lower than that of the control group(P<0.05);the number of blood transfusion in the observation group was5,which was lower than that of the control group(11people,P<0.05);the value of the hemoglobin in the control group was(80.61±13.95)g/L,which was significantly lower than that of the observation group(96.88±16.36)g/L(P<0.05).Conclusion:Topical application of tranexamic acid in total hip arthroplasty is effective in reducing blood loss and blood transfusion volume.