重复静脉注射氨甲环酸对初次单侧全髋关节置换术的疗效和安全性研究

发布时间：2018-06-22 05:01

本文选题：氨甲环酸 + 关节成形术　；参考：《重庆医学》2017年04期

【摘要】：目的探讨重复静脉注射(简称静注)氨甲环酸(TXA)对单侧全髋关节置换术(THA)的疗效和安全性。方法选取2012年1月至2015年6月四川省成都市龙泉驿区第一人民医院收治的102例行初次单侧THA的患者为研究对象,分为单次静注组(术前20min缓慢静注15mg/kg的TXA,n=49)和重复静注组(术前20min缓慢静注15mg/kg的TXA+术后3h再次静注10mg/kg的TXA,n=53)。比较两组的术前基线资料、围术期指标及并发症。结果两组的术前基线资料比较,差异均无统计学意义(P0.05),具有可比性。单次静注组的手术总出血量、平均输血量、术后引流量、术后第3天时血红蛋白(Hb)的下降值、术后住院时间均显著高于重复静注组,差异均有统计学意义(P0.05)。两组的手术时间、输血率比较,差异均无统计学意义(P0.05)。全部患者均未发生深静脉血栓(DVT)、肺栓塞(PE)、切口感染等并发症,两组的肌间静脉血栓、切口渗液、局部血肿等发生率比较,差异均无统计学意义(P0.05)。结论与术前15mg/kg单次静注相比,术后3h重复静注TXA能更有效地控制围术期失血量,且不增加血栓性事件的风险,安全可靠,值得临床推广应用。
[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.
【作者单位】：四川省成都市龙泉驿区第一人民医院骨科;四川大学华西医院骨科;
【分类号】：R687.4

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