氨甲环酸联合自体血回吸收系统在人工全髋关节置换中的应用研究

Study on the application value of tranexamic acid combined with autologous blood resorption system in total hip arthroplasty

目的:分析氨甲环酸联合自体血回吸收系统在人工全髋关节置换术中的应用效果。方法:选择行人工全髋关节置换治疗的晚期股骨头坏死病人84例(88髋),其中观察组42例(45髋),采用氨甲环酸联合自体血回吸收系统;对照组42例(43髋),采用自体血回吸收系统,记录2组病人的手术时间、术中出血量、自体血回吸收量、术后引流量、术中输血情况及术后血常规的变化。结果:2组病人手术时间和自体血回吸收量差异无统计学意义(P>0.05),观察组术中出血量、术后引流量、术中输血率均低于对照组,差异有统计学意义(P<0.01);2组病人术前RBC、Hb、HCT均高于术后1、3、7 d,差异有统计学意义(P<0.05);且术前观察组和对照组RBC、Hb、HCT差异无统计学意义,术后1、3、7 d RBC和Hb水平,术后1和7 d HCT水平,观察组均高于对照组,差异均有统计学意义(P<0.01),术后3 d病人HCT,观察组和对照组差异无统计学意义(P>0.05)。结论:氨甲环酸联合自体血回吸收系统可以明显减少人工全髋关节置换术的失血量,降低输血率,促进病人恢复,缩短住院时间。

Objective:To analyze the application effects of tranexamic acid combined with autologous blood resorption system in total hip arthroplasty.Methods:Eighty-four advanced femoral head necrosis patients(88 hips)treated with total hip arthroplasty were divided into the observation group(42 cases treated with tranexamic acid combined with autologous blood resorption system)and control group(43 cases treated with autologous blood resorption system).The operation time,intraoperative bleeding,auto blood resorption,postoperative drainage,intraoperative blood transfusion and postoperative blood routine in two groups were recorded.Results:The differences of the operation time and autologous blood resorption system were not statistically significant between two groups(P>0.05).The intraoperative bleeding,postoperative drainage and intraoperative blood transfusion rate in observation group were significantly lower than those in control group(P<0.01).The preoperative RBC,Hb and HCT levels in two groups were significantly higher than those after 1,3 and 7 days of operation(P<0.05).The differences in the levels of RBC,Hb and HCT before operation were not statistically significant between two groups(P>0.05).The levels of RBC and Hb after 1,3 and 7 days of operation,and HCT levels after 1 and 7 days of operation in observation group were higher than those in control group(P<0.01).The difference of the level of HCT after 3 days of operation was not statistically significant between two groups(P>0.05).Conclusions:The tranexamic acid combined with autologous blood resorption system can significantly reduce the blood loss of total hip arthroplasty,reduce the blood transfusion rate,promote the recovery and shorten the length of stay of patients.