本文選題：氨甲環(huán)酸 + 關(guān)節(jié)成形術(shù)　； 參考：《重慶醫(yī)學》2017年04期

【摘要】：目的探討重復靜脈注射(簡稱靜注)氨甲環(huán)酸(TXA)對單側(cè)全髖關(guān)節(jié)置換術(shù)(THA)的療效和安全性。方法選取2012年1月至2015年6月四川省成都市龍泉驛區(qū)第一人民醫(yī)院收治的102例行初次單側(cè)THA的患者為研究對象,分為單次靜注組(術(shù)前20min緩慢靜注15mg/kg的TXA,n=49)和重復靜注組(術(shù)前20min緩慢靜注15mg/kg的TXA+術(shù)后3h再次靜注10mg/kg的TXA,n=53)。比較兩組的術(shù)前基線資料、圍術(shù)期指標及并發(fā)癥。結(jié)果兩組的術(shù)前基線資料比較,差異均無統(tǒng)計學意義(P0.05),具有可比性。單次靜注組的手術(shù)總出血量、平均輸血量、術(shù)后引流量、術(shù)后第3天時血紅蛋白(Hb)的下降值、術(shù)后住院時間均顯著高于重復靜注組,差異均有統(tǒng)計學意義(P0.05)。兩組的手術(shù)時間、輸血率比較,差異均無統(tǒng)計學意義(P0.05)。全部患者均未發(fā)生深靜脈血栓(DVT)、肺栓塞(PE)、切口感染等并發(fā)癥,兩組的肌間靜脈血栓、切口滲液、局部血腫等發(fā)生率比較,差異均無統(tǒng)計學意義(P0.05)。結(jié)論與術(shù)前15mg/kg單次靜注相比,術(shù)后3h重復靜注TXA能更有效地控制圍術(shù)期失血量,且不增加血栓性事件的風險,安全可靠,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the efficacy and safety of repeated intravenous injection (TXA) in unilateral total hip arthroplasty (tha). Methods from January 2012 to June 2015, 102 patients with primary unilateral tha were selected from the first people's Hospital of Longquanyi District, Chengdu, Sichuan Province. The patients were divided into single intravenous injection group (preoperative 20min slowly intravenous injection of 15mg/kg TXAnnm49) and repeated intravenous injection group (preoperative 20min slow intravenous injection of 15mg/kg TXANAN 53 at 3 hours after TXAX). Baseline data, perioperative parameters and complications were compared between the two groups. Results there was no significant difference in baseline data between the two groups (P0.05). In the single intravenous injection group, the total blood loss, average blood transfusion volume, postoperative drainage volume, the decrease of hemoglobin (HB) on the 3rd day after operation and the postoperative hospitalization time were significantly higher than those in the repeated intravenous injection group (P0.05). There was no significant difference in operation time and blood transfusion rate between the two groups (P0.05). No deep venous thrombosis (DVT), pulmonary embolism (PE), incision infection and other complications occurred in all the patients. There was no significant difference in the incidence of intramuscular venous thrombosis, incision effusion and local hematoma between the two groups (P0.05). Conclusion compared with preoperative single intravenous injection of 15mg/kg, repeated intravenous injection at 3 hours after operation is more effective in controlling perioperative blood loss and does not increase the risk of thrombotic events. It is safe and reliable and is worthy of clinical application.
【作者單位】： 四川省成都市龍泉驛區(qū)第一人民醫(yī)院骨科;四川大學華西醫(yī)院骨科;
【分類號】：R687.4

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