全髋关节置换术中静脉联合局部应用氨甲环酸减少围术期出血量

The combined administration of intravenous and local tranexamic acid on reducing perioperative blood loss during total hip arthroplasty

目的探讨全髋关节置换术(THA)中静脉联合局部应用氨甲环酸(TXA)对围术期出血量的影响。方法将70例初次行THA患者按是否静脉联合局部应用TXA分为观察组(静脉联合局部应用TXA,35例)和对照组(不应用TXA,35例)。比较两组手术时间、术后住院时间、血液管理相关指标、深静脉血栓(DVT)及肺栓塞(PE)发生率。结果患者均获得2个月随访。手术时间两组比较差异无统计学意义(P=0.32);术后住院时间、术后引流量、总出血量观察组均明显短(少)于对照组(P<0.05);术后血红蛋白最大下降量、输血率观察组均明显小(低)于对照组(P<0.05)。术后2个月两组均未发生DVT及PE。结论在THA中静脉联合局部应用TXA可减少围术期出血量,且不增加患者术后DVT及PE发生风险,安全性较好。

Objective To investigate the influence of combined administration of intravenous and local tranexamic acid(TXA)on perioperative blood loss during total hip arthroplasty(THA).Methods Seventy patients undergoing primary THA were divided into the observation group(35 cases were used combination of intravenous and local TXA)and the control group(35 cases did not use TXA).The operation time,the postoperative hospital stay,blood management related indicators and the rate of deep vein thrombosis(DVT)or pulmonary embolism(PE)were compared between the two groups.Results All patients were followed up for 2 months.There was no significant difference in operation time between the two groups(P=0.32).The postoperative hospital stay,postoperative drainage volume and total blood loss in the observation group were significantly less than those in the control group(P<0.05);and the observation group was significantly smaller(lower)than the control group in the maximum decrease value in hemoglobin and blood transfusion rate(P<0.05).There were no DVT and PE events in both groups at 2 months postoperation(P<0.05).Conclusions The combined administration of intravenous and local TXA can reduce perioperative blood loss in primary THA,and does not increase the risk of postoperative DVT and PE,with better safety.