氨甲环酸对髋翻修患者围术期输血及凝血功能的影响

发布时间：2018-05-01 14:39

本文选题：髋关节翻修 + 氨甲环酸　；参考：《中国老年学杂志》2017年14期

【摘要】：目的探讨氨甲环酸(TXA)对髋翻修患者围术期输血和凝血功能的影响。方法 60例患者随机分为两组,30例术中给予TXA的同时进行自体血回收,另外30例术中只进行自体血回收。记录患者的基本资料、手术时间、自体血回输量、失血量、异体输血量、术后24 h伤口引流量,术前、术中、术后采集病人血样检查主要血液指标以及血栓弹力曲线。采血时间点分别有术前(T0)、术中1 h(T1)、术后完成即刻(T2)、术后6 h(T3)、术后24 h(T4)。将记录的数据进行统计分析。结果两组基本资料、手术时间、自体血回输量无统计学差异(P0.05),TXA组失血量、异体输血量及术后引流量均明显低于对照组(P0.05);TXA组术中及术后血红蛋白(Hb)、血小板(PLT)计数明显高于对照组(P0.05);血栓弹力曲线(TEG)参数中,TXA组T2、T3时刻的活化凝血时间(ACT)显著低于对照组,切角(Angle)、血栓最大弹力度(MA)显著高于对照组(P0.05)。结论TXA用于髋关节翻修术,可以改善患者凝血功能,减少围术期失血及异体输血量。
[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.
【作者单位】：北京积水潭医院麻醉科;
【分类号】：R614

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