氨甲环酸在创伤骨科手术中应用及对患者不良反应发生率的影响

Application of Tranexamic Acid in Trauma Orthopedic Surgery and Its Effect on the Incidence of Adverse Reactions in Patients

目的探究氨甲环酸(TXA)在创伤骨科手术中应用及对患者不良反应发生率的影响。方法选择2019年1月—2020年1月该院收治的90例实施手术的创伤骨科患者作为研究对象,按密封信封法将其等分为对照组和观察组,观察组术前30 min及间隔8 h后静脉输注15 mg/kg氨甲环酸,对照组在相同时间节点输注等量生理盐水,对比两组围术期指标、凝血功能指标、炎症因子指标及不良反应发生率。结果观察组围术期指标中术中失血量明显低于对照组,两组比较差异有统计学意义(t=4.576,P<0.001);观察组术后凝血功能指标中的纤维蛋白降解产物(FDP)指标明显低于对照组,两组比较差异有统计学意义(t=15.039,P<0.001);观察组术后血清指标中的C反应蛋白(CRP)指标明显低于对照组,两组比较差异有统计学意义(t=14.173,P<0.001);观察组不良反应总发生率为6.67%,明显低于对照组的22.22%,两组比较差异有统计学意义(χ^(2)=5.414,P<0.05)。结论氨甲环酸在创伤骨科手术中具有良好的止血效果,且安全性较高,值得推广和应用。

Objective To investigate the application of tranexamic acid(TXA)in trauma orthopedic surgery and its effect on the incidence of adverse reactions in patients.Methods From January 2019 to January 2020,90 traumatic orthopedic patients who underwent surgery in the hospital were selected as the research objects,and they were equally divided into the control group and the observation group according to the sealed envelope method.The observation group received intravenous infusion of 15 mg/kg tranexamic acid 30 minutes before and after 8 hours,and the control group received the same amount of normal saline at the same time point.The perioperative indicators,coagulation function indicators,inflammatory factors indicators and incidence of adverse reactions were compared between the two groups.Results The intraoperative blood loss volume in the perioperative period of the observation group were significantly lower than those of the control group,the difference between the two groups was statistically significant(t=4.576,P<0.001).The fibrin degradation products(FDP)indexes in the postoperative coagulation function indexes of the observation group were significantly lower than those of the control group,the difference between the two groups was statistically significant(t=15.039,P<0.001).The C-reactive protein(CRP)indexes in the postoperative serum indexes of the observation group were significantly lower than those of the control group,the difference between the two groups was statistically significant(t=14.173,P<0.001).The total incidence of adverse reactions in the observation group was 6.67%,which was significantly lower than that in the control group 22.22%,the difference between the two groups was statistically significant(χ^(2)=5.414,P<0.05).Conclusion Tranexamic acid has good hemostatic effect and high safety in trauma orthopedic surgery,which is worthy of promotion and application.