氨甲环酸用于膝关节置换术围术期血液管理40例疗效评价

Application of Tranexami Acid in Blood Management for Total Knee Arthroplasty Perioperative in 40 Cases

目的探讨氨甲环酸在膝关节置换术围术期血液管理中的临床疗效。方法选择2014年1月至9月医院收治的膝关节置换术患者80例,按随机数字表法分为对照组(术毕松止血带前静脉滴注0.9%氯化钠注射液)和治疗组(术毕松止血带前静脉滴注氨甲环酸),各40例。比较两组围术期失血量、输血量及术后并发症的发生情况。结果与对照组相比,治疗组术后输血量及围术期总失血量均明显减少(P<0.05),术后皮下瘀斑发生率显著降低(P<0.05);两组均未发生深静脉血栓形成及肺栓塞等严重并发症。结论氨甲环酸能明显减少膝关节置换术的失血量及输血量,降低术后皮下瘀斑发生率,且不增加术后深静脉血栓及肺栓塞形成风险,值得临床推广。

Objective To investigate the effect of tranexami acid( TXA) on perioperative application of blood management in total knee arthroplasty.Method 80 patients with knee arthroplasty in the hospital from January to September 2014 were randomly divided into the contrl group( intravenous drip of 0.9% saline before the end of the operation) and the treatment group( intravenous drip of TXA before the end of the operation) according to the random number method,40 patients in each group.The bleeding volume on perioperation,blood transfusion and postoperative complications in two groups were compared.Results Compared with the control group,the postoperative blood transfusion and peioperation total bleeding volume in the treatment group were significantly reduced( P < 0.05),the incidence of subcutaneous ecchymosis in the treatment group was significantly decreased( P < 0.05).None of deep vein thrombosis and pulmonary embolism was occurred in the two groups.Conclusion TXA can significantly reduce the bleeding volume and blood transfusion for patients with knee arthroplasty,reduce the incidence of postoperative subcutaneous ecchymosis without increasing the risk of deep vein thrombosis and pulmonary embolism,it is worthy of clinical promotion.