氨甲环酸静脉滴注联合局部冲洗用于跟骨骨折手术临床评价

Clinical Evaluation of Intravenous Drip of Tranexamic Acid Combined with Topical Flushing of Tranexamic Acid in the Calcaneal Fracture Surgery

目的探讨氨甲环酸静脉滴注联合局部冲洗用于跟骨骨折手术的临床疗效及安全性。方法选取医院2013年6月至2019年5月收治的跟骨骨折患者80例,按是否使用氨甲环酸分为试验组和对照组,各40例。两组患者均采用相同的切开复位植骨内固定术治疗,试验组患者术前15 min静脉滴注氨甲环酸氯化钠注射液1 g(100 m L),术后予1 g局部冲洗切口,对照组患者同法给予等量(100 m L)0.9%氯化钠注射液。结果两组患者手术时间、术中出血量、切口愈合时间比较,差异无统计学意义(P>0.05);试验组患者术后24 h引流量明显少于对照组[(146.6±33.7)m L比(297.7±31.5)m L,P<0.01],血红蛋白水平明显高于对照组[(12.22±1.37)g/dL比(11.07±1.41)g/dL,P<0.01],切口并发症发生率明显低于对照组(7.50%比25.00%,P=0.034<0.05);两组患者静脉血栓性疾病发生率及氨甲环酸不良反应发生率无明显差异(P>0.05)。结论氨甲环酸静脉滴注联合局部冲洗用于跟骨骨折手术,可减少患者术后的出血量及并发症,促进切口愈合,且不升高静脉血栓性疾病及氨甲环酸不良反应的发生率。

Objective To investigate the clinical efficacy of intravenous drip of tranexamic acid combined with local flushing of tranexamic acid in the calcaneal fracture surgery.Methods A total of 80 patients with calcaneal fracture admitted to our hospital from June 2013 to May 2019 were selected and divided into the experimental group and the control group according to whether or not they had received tranexamic acid,40 cases in each group.The patients in the two groups were treated with the same open reduction and bone graft and internal fixation.The patients in the experimental group were intravenously injected with 1 g(100 m L)of Tranexamic Acide and Sodium Chloride Injection at 15 min before the surgery,and then they were given local flushing of tranexamic acid(1 g)after the surgery.The patients in the control group were given the same volume(100 m L)of 0.9%Sodium Chloride Injection by the same method.Results There was no significant difference in the duration of surgery,intraoperative blood loss and incision healing time between the two groups(P>0.05).The 24 h drainage volume in the experimental group was significantly lower than that in the control group[(146.6±33.7)m L vs.(297.7±31.5)m L,P<0.01],the hemoglobin level in the experimental group was significantly higher than that in the control group[(12.22±1.37)g/dL vs.(11.07±1.41)g/d L,P<0.01],the incidence of incision complications in the experimental group was significantly lower than that in the control group(7.50%vs.25.00%,P=0.034<0.05).There was no significant difference in the incidence of venous thrombotic diseases and adverse reactions induced by tranexamic acid between the two groups(P>0.05).Conclusion Intravenous drip of tranexamic acid combined with local flushing of tranexamic acid in the calcaneal fracture surgery can reduce the postoperative blood loss and postoperative complications,promote incision healing,without increasing the incidence of venous thrombotic diseases and adverse reactions induced by tranexamic acid.