氨甲环酸在全髋关节置换术患者中的应用效果及对血红蛋白的影响研究

Application Effect of Tranexamic Acid in Patients Undergoing Total Hip Replacement and Its Influence on Hemoglobin

目的:探讨氨甲环酸在全髋关节置换术患者中的应用效果及对血红蛋白的影响。方法:选取2016年2月—2022年2月揭阳市人民医院骨外科一区行全髋关节置换术的50例患者为研究对象,随机分为两组,对照组围手术期不使用氨甲环酸,研究组术前、术毕使用氨甲环酸。比较两组术前、术后1 d血细胞比容、血红蛋白变化情况,比较两组输血量、总失血量、术后引流血量、术中出血量、凝血功能及并发症发生情况。结果:术后1 d,两组血细胞比容、血红蛋白较术前均下降,但研究组高于对照组,差异有统计学意义(P<0.05)。研究组输血量、总失血量、术后引流血量、术中出血量少于对照组,差异有统计学意义(P<0.05)。两种手术前后凝血功能比较,差异无统计学意义(P>0.05)。两组术后均未发生下肢静脉血栓、肺栓塞、伤口内血肿、伤口感染等并发症。结论:术前静滴及术毕注射氨甲环酸应用在全髋关节置换术患者治疗中,能显著减少围手术期失血量,获得较为理想的止血效果,凝血功能无明显异常,不会增加肺栓塞诱发风险。

Objective:To investigate the application effect of Tranexamic Acid in patients undergoing total hip replacement and its influence on hemoglobin.Method:Fifty patients who underwent total hip replacement in the First Section of Orthopedics Surgery,Jieyang People's Hospital from February 2016 to February 2022 were selected as the study objects,they were randomly divided into two groups,the control group was not given Tranexamic Acid during perioperative period,and the study group was given Tranexamic Acid before and after operation.The changes of hematocrit and hemoglobin at before and 1 d after operation were compared between two groups,the blood transfusion volume,total blood loss,postoperative drainage blood volume,intraoperative blood loss,coagulation function and complications were compared between two groups.Result:At 1 d after operation,the hematocrit and hemoglobin of two groups were lower than those before operation,but which in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).The blood transfusion volume,total blood loss,postoperative drainage blood volume and intraoperative blood loss in the study group were less than which in the control group,the differences were statistically significant(P<0.05).There were no significant differences in coagulation function between two groups before and after operation(P>0.05).There were no complications such as lower extremity venous thrombosis,pulmonary embolism,wound hematoma and wound infection in two groups.Conclusion:The application of preoperative intravenous drip and postoperative injection of Tranexamic Acid in the treatment of patients with total hip replacement can significantly reduce perioperative blood loss and obtain ideal hemostatic effect,there is no obvious abnormality in coagulation function and does not increase the risk of pulmonary embolism.