氨甲环酸对老年下肢骨折患者围手术期失血及凝血功能的影响

Effect of Tranexamic Acid on Perioperative Blood Loss and Coagulation Function in Elderly Patients with Lower Extremity Fracture

目的:探讨氨甲环酸对老年下肢骨折患者围手术期失血及凝血功能的影响。方法:回顾性分析2017年9月—2018年12月我院收治的96例老年下肢骨折患者的病例资料,根据治疗方式的不同将所有患者分为两组,各48例。观察组于切皮前10 min静脉单次滴注氨甲环酸(10 mg/kg),对照组仅滴注适量的0.9%氯化钠注射液,比较两组围术期失血量及凝血功能变化。结果:观察组术中失血量、术后引流量、隐性失血量及总失血量均少于对照组,差异有统计学意义(P <0.05);手术进行时、手术完成即刻两组凝血酶原(PT)、活化部份凝血活酶时间(APTT)较术前均有所升高,且观察组高于对照组,差异有统计学意义(P <0.05)。结论:氨甲环酸用于老年下肢骨折患者,可有效减少围术期失血量,改善凝血功能,临床应用价值显著。

Objective:To investigate the effect of tranexamic acid on perioperative blood loss and coagulation function in elderly patients with lower extremity fracture.Methods:The case data of 96 elderly patients with lower extremity fracture admitted to our hospital from September 2017 to December 2018 were retrospectively analyzed,and the patients were divided into two groups according to different treatment methods,48 cases each.The patients in the observation group received single intravenous infusion of tranexamic acid(10 mg/kg)at 10 min before skin incision,and the patients in the control group were only infused with an appropriate amount of normal saline.The perioperative blood loss and coagulation function were compared between the two groups.Results:The blood loss,postoperative drainage volume,recessive blood loss and total blood loss in the observation group were lower than those in the control group,and the differences were statistically signi?cant(P<0.05).The levels of PT and APTT at the time of operation and the time of operation completion were higher than those before operation in the two groups,and the levels in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:Tranexamic acid can effectively reduce perioperative blood loss and improve coagulation function in elderly patients with lower extremity fracture,which has signi?cant clinical application value.