本文選題：髖關(guān)節(jié)翻修 + 氨甲環(huán)酸��； 參考：《中國(guó)老年學(xué)雜志》2017年14期

【摘要】：目的探討氨甲環(huán)酸(TXA)對(duì)髖翻修患者圍術(shù)期輸血和凝血功能的影響。方法 60例患者隨機(jī)分為兩組,30例術(shù)中給予TXA的同時(shí)進(jìn)行自體血回收,另外30例術(shù)中只進(jìn)行自體血回收。記錄患者的基本資料、手術(shù)時(shí)間、自體血回輸量、失血量、異體輸血量、術(shù)后24 h傷口引流量,術(shù)前、術(shù)中、術(shù)后采集病人血樣檢查主要血液指標(biāo)以及血栓彈力曲線。采血時(shí)間點(diǎn)分別有術(shù)前(T0)、術(shù)中1 h(T1)、術(shù)后完成即刻(T2)、術(shù)后6 h(T3)、術(shù)后24 h(T4)。將記錄的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果兩組基本資料、手術(shù)時(shí)間、自體血回輸量無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),TXA組失血量、異體輸血量及術(shù)后引流量均明顯低于對(duì)照組(P0.05);TXA組術(shù)中及術(shù)后血紅蛋白(Hb)、血小板(PLT)計(jì)數(shù)明顯高于對(duì)照組(P0.05);血栓彈力曲線(TEG)參數(shù)中,TXA組T2、T3時(shí)刻的活化凝血時(shí)間(ACT)顯著低于對(duì)照組,切角(Angle)、血栓最大彈力度(MA)顯著高于對(duì)照組(P0.05)。結(jié)論TXA用于髖關(guān)節(jié)翻修術(shù),可以改善患者凝血功能,減少圍術(shù)期失血及異體輸血量。
[Abstract]:Objective to investigate the effect of TXA on perioperative blood transfusion and coagulation in patients with hip revision. Methods 60 patients were randomly divided into two groups: 30 patients were treated with TXA and 30 patients were treated with autologous blood recovery. The patient's basic data, operation time, autologous blood volume, blood loss, allogeneic blood transfusion, wound drainage flow 24 hours after operation were recorded. Blood samples were collected before, during and after operation to check the main blood indexes and thromboelastic curve. The time points of blood collection were T _ 0 before operation, T _ 1 at 1 hour after operation, T _ 2 after operation, T _ 3 at 6 h after operation, and T _ 4 at 24 h after operation. Statistical analysis of recorded data. Results there was no significant difference between the two groups in the basic data, operation time and the volume of autologous blood transfusion. The volume of allogeneic blood transfusion and postoperative drainage volume were significantly lower than those in the control group (P 0.05), and the counts of HB and PLT were significantly higher than those in the control group (P 0.05), and the thromboelastic curve (TEG) parameters were significantly lower in the TXA group than in the control group in the activated coagulation time at T 2T 3 and T 2 T 3, ACTs were significantly lower than those in the control group, and the platelet count was significantly higher in the TXA group than that in the control group. The maximal elasticity of thrombus (MAA) was significantly higher than that of the control group (P 0.05). Conclusion TXA can improve coagulation function and decrease blood loss and allogeneic blood transfusion in patients with hip revision.
【作者單位】： 北京積水潭醫(yī)院麻醉科;
【分類號(hào)】：R614

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