氨甲环酸在单侧初次全膝关节置换术中的应用分析

发布时间：2018-10-05 17:20

【摘要】：目的:分析在单侧初次全膝关节置换术中应用氨甲环酸(TXA)对围手术期出血、术后输血率及早期膝关节功能的影响。方法:回顾性分析我院在2015年3月至2016年12月间行单侧初次全膝关节置换术(TKA)的患者共78例,根据TXA的使用方法分为三组:A组:术前30min静脉滴注1g TXA(溶于100ml生理盐水),并在关节腔关闭后经引流管膝关节腔内注射1g TXA(25例);B组:单纯膝关节腔内注射1g TXA(28例);C组(25例):对照组,不给予TXA治疗。分别比较三组患者的术中及术后出血量、血红蛋白减少量、术后3月膝关节功能等情况,应用SPSS21.0软件统计分析各组间的差异有无统计学意义。结果:通过比较发现,应用TXA后,患者的术后引流量、隐性失血量、总失血量及血红蛋白减少量较空白对照组均明显减少(P0.05)。由于术中全程使用止血带,故术中出血量三组间未见明显差异(P0.05)。亚组间比较发现,静脉滴注联合关节腔内注射组较单纯关节腔内注射组在术后隐性失血量、总失血量及72H血红蛋白减少量方面未见明显统计学差异(P0.05)。三组患者均有不同程度的输血,但差异无明显统计学意义(P0.05)。所有患者均未发生深静脉血栓、肺栓塞及与TXA相关的并发症。结论:对于行单侧初次全膝关节置换术的患者,在术中使用TXA能够明显减少患者的失血量及血红蛋白丢失量,同时并不会影响术后患者膝关节的功能恢复。
[Abstract]:Objective: to analyze the effect of (TXA) on perioperative bleeding, blood transfusion rate and early knee function in unilateral primary total knee arthroplasty. Methods: a retrospective analysis of 78 patients with (TKA) underwent unilateral initial total knee arthroplasty from March 2015 to December 2016 was performed in our hospital. According to the use of TXA, 30min was divided into three groups: group A: 1 g TXA (dissolved in 100ml saline) was injected intravenously before operation, and 1 g TXA (25 cases) was injected into knee joint through drainage tube after closure of articular cavity. Group B was treated with 1 g TXA (28 cases). Group (25 cases): control group, TXA was not given. The blood loss, hemoglobin reduction and knee joint function in the three groups were compared respectively. The statistical analysis of the difference between the three groups by SPSS21.0 software was not statistically significant. Results: compared with the control group, the volume of drainage, the amount of recessive blood loss, the amount of total blood loss and the decrease of hemoglobin in the patients with TXA were significantly decreased compared with those in the control group (P0.05). Because the tourniquet was used throughout the operation, there was no significant difference among the three groups (P0.05). The results showed that there was no significant difference in recessive blood loss, total blood loss and 72H hemoglobin reduction between intraarticular injection group and intraarticular injection group (P0.05). Three groups of patients with different degrees of blood transfusion, but the difference was not statistically significant (P0.05). No deep venous thrombosis, pulmonary embolism and TXA related complications occurred in all patients. Conclusion: for patients undergoing unilateral primary total knee arthroplasty, the amount of blood loss and hemoglobin loss can be significantly reduced by using TXA during operation, and the functional recovery of knee joint can not be affected after operation.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

【参考文献】