KOA患者术前给予氨甲环酸对凝血功能、下肢血流参数的影响

The Effect of Preoperative Tranexamic Acid on Blood Coagulation Function and Blood Flow Parameters of Lower Limbs in KOA Patients

本研究探讨膝骨关节炎(KOA)患者术前给予氨甲环酸对于内侧开放楔形胫骨高位截骨术患者手术出血量、凝血功能状态、下肢超声血流速度参数的影响。选取拟接受内侧开放楔胫骨高位截骨术的患者94例进行相关研究,采用统计学软件生成的随机数字表将患者分为试验组和对照组,各47例,术前试验组患者给予氨甲环酸,对照组仅给予等量的生理盐水,其余治疗措施保持一致。对比两组患者的手术时间、显性失血量、隐性失血量、总失血量、住院时间,并对比两组患者手术前后的血红蛋白(Hb)、血细胞比容、D-二聚体、血栓弹力图(TEG)参数、下肢静脉平均血流速度。试验组患者的显性失血量、隐性失血量、总失血量均低于对照组(P<0.05);术后72 h,试验组Hb高于对照组(P<0.05);试验组的下肢深静脉血栓(DVT)发生率(4.26%)与对照组(2.13%)比较,差异无统计学意义(P>0.05)。患者术前静滴氨甲环酸有利于减少手术出血量及术后隐性失血量,但是对患者的血栓弹力图(TEG)参数及下肢血流速度影响并不明显,并不会显著增加DVT的发生率。

This study explored the effects of preoperative administration of tranexamic acid on surgical blood loss,blood coagulation status,and lower limb ultrasound blood flow parameters in KOA patients undergoing medial open wedge-shaped high tibial osteotomy.Ninety-four patients who intend to undergo medial open wedge tibial high osteotomy were selected for related research.Using the random number table generated by statistical software,the patients were divided into the test group and the control group with 47 cases in each.The patients in the test group were given preoperatively for tranexamic acid,while only given the same amount of normal saline in the control group instead,and the rest of the treatment measures remained the same.Compared the operation time,apparent blood loss,hidden blood loss,total blood loss and the length of hospital stay between the two groups,and the hemoglobin(Hb),hematocrit,D-dimer,thromboelastogram(TEG)parameters and the average blood flow velocity of the lower limb veins before and after the operation.The apparent blood loss,hidden blood loss,and total blood loss of the test groups were lower than in the control group(P<0.05).Seventy-two hours after the operation,the Hb value of the test group was higher than that in the control group(P<0.05).The incidence of deep vein thrombosis(DVT)in the test group was 4.26%compared with 2.13%in the control group,and the difference was not statistically significant(P>0.05).Preoperative intravenous infusion of tranexamic acid is beneficial to reduce surgical blood loss and postoperative hidden blood loss,but it could not significantly affect the patient’s TEG parameters and lower limb blood flow velocity,and could not significantly increase the incidence of DVT.