不同方式使用氨甲环酸对全膝关节置换术后出血的影响及其安全性

发布时间：2017-12-28 05:42

本文关键词：不同方式使用氨甲环酸对全膝关节置换术后出血的影响及其安全性　出处：《临床骨科杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨不同方式使用氨甲环酸对全膝关节置换术(TKA)患者术后出血的影响及其安全性。方法将154例行初次单侧TKA的患者分为3组:术中局部和静脉联合使用氨甲环酸组(A组,52例),局部使用氨甲环酸组(B组,53例),未使用氨甲环酸组(C组,49例)。比较3组患者术后引流量、输血率、输血量、术后第1、3天血红蛋白值、D-二聚体值及术后下肢深静脉血栓和肺栓塞的发生率。结果术后引流量、输血率、输血量A组低于B、C组(P0.05),B组低于C组(P0.05)。术后第1、3天血红蛋白值A组高于B、C组(P0.05),B组高于C组(P0.05)。术后第1、3天D-二聚体值及下肢深静脉血栓和肺栓塞发生3组比较差异无统计学意义(P0.05)。结论在TKA中联合使用和局部使用氨甲环酸可减少术后出血,联合使用效果更好,且不增加下肢静脉血栓及肺栓塞风险。
[Abstract]:Objective to explore the effect of tranexamic acid on total knee arthroplasty (TKA) effect of postoperative bleeding and safety. Methods 154 patients with unilateral TKA patients were divided into 3 groups: intraoperative topical and intravenous combined with tranexamic acid group (group A, 52 cases), the use of tranexamic acid group (group B, 53 cases of local), without the use of tranexamic acid group (group C, 49 cases). The postoperative drainage volume, blood transfusion rate, blood transfusion volume, hemoglobin value at first, third days after operation, D- two polymer value and incidence of deep venous thrombosis and pulmonary embolism after operation in 3 groups were compared. Results the A group was lower than group B and C (P0.05), and group B was lower than that of group C (P0.05). The hemoglobin value in group A was higher than that in group B and group C (P0.05) first, third days after operation, and in group B was higher than that in group C (P0.05). There was no significant difference between the D- two polymer values and the 3 groups of deep venous thrombosis and pulmonary embolism in the lower extremities (P0.05) first, third days after the operation. Conclusion the combined use of TKA and topical use of tranexamic acid can reduce postoperative bleeding, with better effect, and does not increase the risk of deep vein thrombosis and pulmonary embolism.
【作者单位】：湖州市中心医院骨科;
【分类号】：R687.4
【正文快照】： 人工全膝关节置换术(TKA)术后失血量很大,输血率高达10%~62%[1]。行TKA的患者多为老年患者,对术后大量出血的耐受性较差,出血后关节肿胀会影响功能锻炼,延长功能恢复的时间[2]。因此,如何减少术后出血一直是骨科医师所关注的问题。氨甲环酸主要用于急性或慢性、局限性或全身性

【相似文献】