氨甲环酸对全膝关节置换术中患者失血和输血的影响

Effect of tranexamic acid on blood loss and transfusion in patients with total knee arthroplasty

目的探讨全膝关节置换术中应用氨甲环酸(tranexamic acid, TXA)对于患者围术期失血和输血效果的影响。方法选择2016年1月至2018年12月北京大学第三医院行全膝关节置换术中,全部输注悬浮红细胞及非输注悬浮红细胞患者,共计250例。按照是否输血和术中是否使用TXA分为4组,观察性别比例、年龄、住院天数、输血量及患者术前血常规、凝血功能,术后Hb最低值及输注红细胞次日血常规结果。结果 4组患者性别比例、年龄、住院天数、输血量差异均无统计学意义,术前血常规、凝血功能差异无统计学意义。术中使用TXA可抑制术后红细胞、Hb、红细胞比容(hematocrit, HCT)和PLT下降,使用TXA者输血后Hb恢复更快。结论术中使用TXA可以减少全膝关节置换术患者围术期失血量,促进输血后Hb恢复。

Objective To investigate the effects of tranexamic acid(TXA) on blood loss and transfusion in patients with total knee arthroplasty. Methods Two hundred and fifty patients with total knee arthroplasty in Peking University Third Hospital from January 2016 to December 2018, were selected and divided into choose into four groups according to the blood transfusion and intraoperative use of TXA. Gender ratio, age, hospitalization days, blood transfusion amount, and preoperative blood routine examination and coagulation postoperative blood routine examination and blood transfusion were observed. Results There was no significant difference in gender ratio, age, length of stay and blood transfusion volume among the four groups. There was no significant difference in preoperative blood routine examination and coagulation function among the four groups. The use of TXA during the operation could inhibit the decline of postoperative RBC, hemoglobin, hematocrit and platelet, and was also conducive to the recovery of hemoglobin after blood transfusion. Conclusions Tranexamic acid can reduce perioperative blood loss of total knee arthroplasty and promote the recovery of hemoglobin after transfusion.