不同剂量氨甲环酸对老年股骨颈骨折全髋置换术失血的影响

Effects of different doses of tranexamic acid on blood loss in elderly patients with femoral neck fractures undergoing total hip arthroplasty

目的:分析术前静脉滴注高、低剂量氨甲环酸(tranexamic acid,TXA)对老年股骨颈骨折全髋置换术(total hip arthroplasty,THA)失血的影响。方法:选取THA患者87例,分为低剂量A组(43例,TXA 15 mg/kg)和高剂量B组(44例,TXA 50 mg/kg)。比较两组围手术期失血量,术后血红蛋白减少量,输血量及下肢深静脉血栓形成。结果:两组间显性失血量(DBL)、总失血量(TBL)、术前与术后24 h测得的血红蛋白量差值的比较差异有统计学意义,而输血量及并发症差异无统计学意义。结论:术前0.5 h静脉滴注50 mg/kg高剂量TXA在减少手术失血量方面效果好,且不增加血栓等并发症形成风险。

Objective:To analyze the clinical effect of preoperative intravenous infusion of high-or low-dose tranexamic acid(TXA)on blood loss in elderly patients with femoral neck fracture undergoing total hip arthroplasty(THA).Methods:A total of 87 elderly patients with femoral neck fracture undergoing THA were selected and divided into group A(43 cases,TXA 15 mg/kg)and group B(44 cases,TXA 50 mg/kg).Perioperative blood loss,postoperative hemoglobin reduction,blood transfusion volume,lower limbs deep vein thrombosis were compared between the two groups.Results:There were significant differences between the two groups in dominant blood loss(DBL),total blood loss(TBL),the difference of hemoglobin content determined between pre-operation and 24 hours after operation,but not in blood transfusion volume and incidence of complications.Conclusion:High-dose TXA(50 mg/kg)given intravenously at 0.5 h before surgery has good effect in reducing blood loss without increasing the risk of complications such as thrombosis.