人工膝关节置换术后应用氨甲环酸对患者失血、创面修复及关节功能恢复影响的临床研究

Effect of tranexamic acid on hemorrhage,wound healing and joint function recovery after total knee arthroplasty

目的探讨人工膝关节置换术后应用氨甲环酸对患者失血、创面修复及关节功能恢复的影响。方法选取60例行人工膝关节置换术的患者作为研究对象,将患者随机分为观察组与对照组,每组30例。对照组术后给予生理盐水静脉滴注,观察组给予氨甲环酸静脉滴注,对比2组患者术中、术后相关指标,凝血指标,以及美国膝关节协会(KSS)功能评分与膝关节活动度。结果观察组患者隐性失血量、总失血量、术后引流量、引流时间、创面干燥时间以及创面愈合时间明显低于对照组(P<0.05);手术前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)指标对比差异无统计学意义(P>0.05);术后3个月2组患者KSS功能评分与膝关节活动度均提高,且观察组高于对照组(P<0.05)。结论人工膝关节置换术后患者应用氨甲环酸,能够减少患者术后失血量,促进创面修复,不影凝血功能,可提升患者术后的膝关节功能。

Objective To investigate the effect of tranexamic acid on hemorrhage,wound repair and joint function recovery after total knee arthroplasty.Methods 60 patients with total knee arthroplasty treated were selected as the research object.The patients were randomly divided into the observation group and the control group,with 30 cases in each group.The control group was given normal saline intravenous drip after operation,and the observation group was given tranexamic acid intravenous drip.The intraoperative and postoperative related indexes,coagulation indexes,American Knee Association(KSS)functional score and knee range of motion were compared between the two groups.Results The hidden blood loss,total blood loss,postoperative drainage volume,drainage time,wound drying time and wound healing time in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)before and after operation(P>0.05).Three months after operation,the KSS function score and knee joint activity of the two groups were improved,and the observation group was higher than that of the control group(P<0.05).Conclusion Tranexamic acid can reduce postoperative hemorrhage,promote wound repair and do not affect coagulation function.It can improve postoperative knee function.