氨甲环酸对老年患者股骨转子间骨折手术失血量的影响

Effect of tranexamic acid on blood loss in elderly patients during intertrochanteric fracture surgery

目的研究氨甲环酸对老年患者股骨转子间骨折手术失血量的影响。方法选择66例股骨转子骨折老年患者,随机分为试验组与对照组。术前30 min试验组静脉滴注氨甲环酸,对照组滴注生理盐水。比较两组手术时间、术中出血量、围手术期出血量、显性出血量、隐性出血量、术后不同时间血红蛋白浓度和红细胞比容等指标。结果试验组与对照组的手术治疗时间比较无统计学差异(P> 0.05),但试验组患者的术中出血量、围手术期出血量、显性出血量以及隐形出血量均显著低于对照组(P <0.05)。在术后1~14 d,试验组Hb和Hct均呈先降低(P <0.05),然后逐渐升高的变化趋势,且在第5 d后均高于同时点对照组。而对照组Hb和Hct术后均显著降低(P <0.05),且直到术后第14 d也无显著恢复。结论股骨转子间骨折老年患者术前给予氨甲环酸,可以有效减少患者的手术失血量,有助于患者的恢复,值得临床广泛使用。

Objective To study the effect of tranexamic acid on the blood loss in elderly patients during intertrochanteric fracture surgery. Methods A total of 66 elderly patients with intertrochanteric fracture were selected and randomly divided into an experimental group and a control group. Tranexamic acid was performed on the experimental group via intravenous drip 30 minutes before surgery, and normal saline was on the control group. Such indexes as surgery duration, intraoperative blood loss, perioperative blood loss, overt and occult blood loss, hemoglobin concentration(Hb) and hematocrit value(Hct) at various postoperative time points between the two groups were compared. Results There was no statistically significant difference in surgery duration between the two groups(P > 0.05). The experimental group was significantly lower than the control group in intraoperative blood loss, perioperative blood loss, overt and occult blood loss(P < 0.05). During one to 14 days after the surgery, the Hb and Hct in the experimental group decreased first(P < 0.05), and then lifted gradually, and were higher than the control group after five days. The Hb and Hct in the control group decreased significantly after surgery(P < 0.05), and presented no significant lift on day 14 after surgery. Conclusion Injecting tranexamic acid into elderly patients with intertrochanteric fracture before surgery is associated with less intraoperative blood loss and better recovery, hence it is worth clinical promotion.