联合方式使用氨甲环酸止血对股骨转子间骨折PFNA内固定术隐性失血的临床疗效

Clinical effect of intravenous drip combined with local immersion combined with tranexamic acid hemostasis on recessive blood loss of femoral intertrochanteric fracture PFNA internal fixation

目的分析静滴结合局部浸泡联合方式使用氨甲环酸止血对股骨转子间骨折PFNA内固定术隐性失血的临床疗效。方法选取2018年10月至2019年10月本院收治的股骨转子间骨折接受PFNA内固定术治疗患者62例,随机分为研究组和对照组,各31例。对照组给予静脉滴注氨甲环酸治疗,研究组给予静脉滴注联合局部浸泡氨甲环酸治疗。比较两组手术时间、骨折愈合时间、隐性失血量、显性失血量、失血总量、术后Hb下降最大值及不良反应发生率。结果研究组手术以及骨折愈合时间与对照组比较差异无统计学意义;研究组隐性失血量、显性失血量、总失血量以及术后Hb下降最大值均低于对照组(P<0.05);研究组不良反应发生率与对照组比较差异无统计学意义。结论股骨转子间骨折接受PFNA内固定术患者联合使用静滴和局部浸泡氨甲环酸治疗效果理想,可有效减少患者的出血量,值得临床推广。

Objective To analyze the clinical effect of tranexamic acid hemostasis combined with intravenous drip and local immersion in treatment recessive blood loss of femoral intertrochanteric fracture internal fixation with PFNA.Methods 62 patients with intertrochanteric fractures treated with PFNA internal fixation in our hospital from October 2018 to October 2019 were randomly divided into study group and control group,with 31 cases in each group.The control group was treated with intravenous tranexamic acid infusion,and the study group was treated with intravenous tranexamic acid infusion and local tranexamic acid immersion.The operative time,fracture healing time,recessive blood loss,dominant blood loss,total blood loss,postoperative Hb decline maximum and the incidence of adverse reactions were compared between the two groups.Results There was no significant difference in the operation and fracture healing time between the study group and the control group.The recessive blood loss,dominant blood loss,total blood loss and postoperative Hb decrease in the study group were all lower than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group and the control group.Conclusion Intravenous drip and local immersion of tranexamic acid can effectively reduce the amount of blood loss in patients with intertrochanteric fractures treated with PFNA internal fixation.