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氨甲环酸多次静脉给药在胫骨高位截骨术中的安全性与抗炎作用

To Investigate the Safety and Anti-inflammatory Effects of Tranexamic Acid on High Tibial Osteotomy
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摘要 目的探讨氨甲环酸多次静脉给药在胫骨高位截骨术中的安全性和抗炎作用。方法采用临床随机对照的方法将224例符合行胫骨高位截骨术标准的患者病例纳入研究。依据氨甲环酸研究方案分为A组(112例)男58例,女54例;平均年龄(49.33±6.83)岁;切皮前10~15 min给予氨甲环酸15 mg/kg,术后3 h、6 h及9 h各再次静脉给予1 g。B组(112例)男49例,女63例;平均年龄(52.21±6.28)岁;切皮前10~15 min给予15 mg/kg氨甲环酸,3 h后静脉再给予1 g。记录并比较两组患者总失血量、术后隐性失血量、术后24h引流量、手术时间、术后3 d抗炎因子(C反应蛋白、白细胞介素-6及血沉)、静脉血栓发生率、伤口并发症及其他并发症情况。结果所有患者随访时间9个月。A组患者术后总失血量、隐性失血量和术后24 h引流量均明显低于B组,且差异有统计学意义(P<0.05)。A组患者术后1 d、3 d、5 d C反应蛋白、白细胞介素-6及血沉均低于B组,差异有统计学意义(P<0.05);A组患者术后1 d、3 d、5 d患肢周径值和瘀斑血肿发生率均低于B组,且差异有统计学意义(P<0.05);两组患术后1 d、术后2周、术后4周深静脉血栓形成发生率比较,差异均无统计学意义(P>0.05);两组患术前、术后1个月、术后3个月及手术时间比较,差异均无统计学意义(P>0.05);两组患者术后2周无呼吸系感染与肺栓塞发生,B组患者有1例泌尿系感染。结论氨甲环酸多次静脉给药在减少胫骨高位截骨术患者围手术期失血量的同时不增加静脉血栓发生率,且随着给药次数的增加具有显著的抗炎效果。 Objective To investigate the safety and anti-inflammatory effects of tranexamic acid(TXA)on high tibial osteotomy(HTO).Methods 224 patients who met the criteria for high tibial osteotomy were included in the study using a randomized controlled clinical method.112 cases were included in group A including 58 males and 54 females.The average age was(49.33±6.83)years.TXA was administered 10 to 15 minutes before dermectomy,and another 1 g was intravenously 3 h,6 h and 9 h after surgery.Group B had 112 cases,including 49 males and 63 females.The average age was(52.21±6.28)years.15 mg/kg TXA was given 10~15 min before dermectomy,and another 1 g was given intravenously 3 h later.according to the TXA study plan.All patients were followed up for 9 months.Total blood loss,postoperative recessive blood loss,postoperative drainage volume at 24 hours,operative time,anti-inflammatory factors including C-reactive protein(CRP)、interleukin 6(IL-6)and erythrocyte sedimentation rate(ESR)3 days after surgery.Incidence of venous thrombosis,wound complications,and other complications were recorded and compared between the two groups.Results All patients were followed up for 9 months.The total postoperative blood loss,the recessive blood loss and the 24 h postoperative drainage volume of patients in the A group were significantly lower than those in the B group,and the differences were significant(P<0.05).CRP,IL-6and ESR were all lower in group A than in group B at 1,3 and 5 days after surgery,and the differences were statistically significant(P<0.05).The peri-menstrual value of the affected limb and the incidence of ecchymosis hematoma in group A 1,3 and 5 days after surgery were all lower than those in group B,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of deep vein thrombosis between the two groups at 1 day,2 weeks and 4 weeks after surgery(P>0.05).There was no significant difference in WOMAC score and operation time between the two groups before surgery,1 month and 3 months after surgery(P>0.05).There was no respiratory infection or pulmonary embolism in the two groups,and there was 1 case of urinary infection in group B,two weeks after the operation.Conclusion Repeated administration of TXA reduced perioperative blood loss in patients undergoing HTO without increasing the incidence of venous thrombosis,and showed significant anti-inflammatory effects with the increase of administration times.
作者 何伟 王敏 任敬 廖永华 乔峰 赵静静 黄小强 He Wei;Wang Min;Ren Jing(Shaanxi University of Trditional Chinese Medicine,Xianyang 710054,China;Department of Orthopedics,Honghui Hospital,Xi’an Jiaotong University,Xi’an 710001,China)
出处 《实用骨科杂志》 2021年第10期875-880,共6页 Journal of Practical Orthopaedics
基金 国家自然科学基金青年项目(81702213) 陕西省重点研发计划项目(2019S-F192) 陕西省重点研发计划项目(2018SF-195) 陕西省重点研发计划项目(2018SF-201)。
关键词 氨甲环酸 胫骨 截骨术 静脉血栓栓塞 抗炎因子 并发症 tranexamic acid tibia osteotomy venous thromboembolism anti-inflammatory factor complication
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  • 1常光其,陈翠菊,陈忠,董国祥,段志泉,符伟国,戈小虎,谷涌泉,管珩,郭平凡,郭曙光,郭伟,姜维良,蒋米尔,金毕,金辉,金星,景在平,赖传善,李鸣,李晓强,李毅清,李震,林勇杰,刘冰,刘昌伟,刘长建,刘鹏,马杰,潘松龄,时德,舒畅,谭最,王劲松,王深明,王玉琦,汪忠镐,吴丹明,吴庆华,吴向未,辛世杰,叶建荣,苑超,张柏根,张福先,张鸿坤,张纪蔚,张小明,赵纪春,赵渝,周晗.慢性下肢静脉疾病诊断与治疗中国专家共识[J].中国血管外科杂志(电子版),2014,6(3):143-151. 被引量:184
  • 2王飞,陈百成,高石军,段德胜.关节镜并胫骨高位截骨术治疗膝内翻骨关节炎[J].河北医药,2005,27(6):413-414. 被引量:10
  • 3Ickx BE, Van der Linden PJ, Melot C, et al. Comparison of the effects of aprotinin and tranexamic acid on blood loss andpacked red blood cell transfusion requirements during the late sta- ges of liver transplantation[Jl. Transfusion, 2006, 46 (4): 595-605.
  • 4Electronic Medicines Compendium. Tranexamic acid 100 mg/ml solution for injection [ EB/OL ]. [ 2014-7-24 ]. http ://~'ww.med- icines, org. uk/emc/medicine/28163, html.
  • 5Dirkmann D, Radtl-Berlemann J, G~rlinger K, et al. Recombinant tissue-type plasminogen activator-evoked hyperfibrinolysis is en- hanced by acidosis and inhibited by hypothermia but still can be blocked by tranexamic acid[Jl. J Trauma Acute Care Surg, 2013,74(2) :482-488.
  • 6Wang SC, Lin HT, Chang KY, et al. Use of higher throm- boelastogram transfusion values is not associated with greater blood loss in liver transplant surgery [J]. Liver Transpl,2012, 1 8 (10) : 1253-1258.
  • 7Rahman L, Oussedik S. Patient preparation for total knee ar- throplasty: reducing blood loss, thromboprophylaxis and re- ducing infection risk//Total Knee Arthroplasty. Germany: Springer, 2015: 57-67.
  • 8Chiung-Jui Su D, Yuan KS, Weng SF, et al. Can early rehabil- itation after total hip arthroplasty reduce its major complica- tions and medical xxpenses? Report from a nationally repre- sentative cohort. Biomed ResInt, 2015, 2015: 641958.
  • 9Van Egmond JC, Verburg H, Mathijssen NM. The first 6 weeks of recovery after total knee arthroplasty with fast track: A diary study of 30 patients. Acta orthop, 2015, 86(6): 708-713.
  • 10D'Lima DD, Colwell CWJr, Morris BA, et al. The effect of preoperative exercise on total knee replacement outcomes. Clin Orthop Relat Res, 1996, (326): 174-182.

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