静脉滴注氨甲环酸对膝关节置换手术患者失血量及血栓性并发症的影响

Effect of Intravenous Infusion of Tranexamic Acid on Blood Loss and Thrombotic Complications in Patients Undergoing Knee Replacement Surgery

目的探讨静脉滴注氨甲环酸对膝关节置换手术患者失血量及血栓性并发症的影响。方法于2016年3月—2018年12月方便选取膝关节置换手术患者92例,按照随机数字表法,分为对照组和观察组,各46例。全身麻醉诱导期,对照组采用0.9%氯化钠溶液静脉滴注,观察组采用10 mg/kg氨甲环酸静脉滴注,比较两组失血情况、并发症发生率和膝关节恢复情况。结果观察组输血率为6.52%,低于对照组的41.30%(χ^2=15.294,P<0.05);观察组术后引流量[(380.3±50.2)mL vs(470.6±84.5)mL,t=6.231]、总失血量[(842.1±105.2)mL vs(1014.9±265.8)mL,t=4.100]和输血量[(248.5±62.1)mL vs(411.6±123.2)mL,t=8.018]均少于对照组(P<0.05);手术治疗后,观察组小腿周径[(44.1±1.2)cm vs(48.0±2.1)cm,t=10.936]、髌上10 cm周径[(35.7±1.4)cm vs(40.1±2.2)cm,t=11.444]短于对照组,KSS评分[(58.8±6.3)分vs(49.8±5.1)分,t=7.531]高于对照组,差异有统计学意义(P<0.05)。结论膝关节置换手术中应用氨甲环酸静脉滴注,可使患者失血量减少,加快患者机体膝关节康复进度,同时不会明显增加血栓性并发症的发生。

Objective To investigate the effect of intravenous infusion of tranexamic acid on blood loss and thrombotic complications in patients undergoing knee replacement surgery.Methods A total of 92 patients with knee replacement surgery were convenient selected and enrolled from March 2016 to December 2018.According to the random number table method,they were divided into control group and observation group,with 46 cases in each group.During the induction period of general anesthesia,the control group was intravenously instilled with 0.9%sodium chloride solution.The observation group was treated with 10 mg/kg tranexamic acid intravenously.The blood loss,complication rate and knee recovery were compared between the two groups.Results The blood transfusion rate of the observation group was 6.52%,which was lower than that of the control group 41.30%(χ^2=15.294,P<0.05).The drainage volume of the observation group was[(380.3±50.2)mL vs(470.6±84.5)mL,t=6.231],blood loss in total[(842.1±105.2)mL vs(1014.9±265.8)mL,t=4.100]and blood transfusion[(248.5±62.1)mL vs(411.6±123.2)mL,t=8.018]were less than the control group(P<0.05);After surgical treatment,the circumference of the lower leg of the observation group[(44.1±1.2)cm vs(48.0±2.1)cm,t=10.936],and the 10 cm circumference of the iliac crest[(35.7±1.4)cm vs(40.1±2.2)cm,t=11.444]shorter than the control group,KSS score[(58.8±6.3)points vs(49.8±5.1)points,t=7.531]was higher than the control group,the difference was statistically significant(P<0.05).Conclusion Intravenous infusion of tranexamic acid in knee replacement surgery can reduce the blood loss of patients and accelerate the progress of knee joint rehabilitation,and will not significantly increase the incidence of thrombotic complications.