CAJ | 학술논문

目的：探讨不同时间使用氨甲环酸对初次行髋关节置换术患者失血量的影响。方法将90例初次行髋关节置换术的患者按随机数字表法分为：早期组（30例，氨甲环酸术前1 h使用）、晚期组（30例，氨甲环酸术中使用）和对照组（30例，不使用）。统计分析患者的显性红细胞丢失量、隐性红细胞丢失量与总红细胞丢失量。结果（1）对照组（96．3±21．7）mL的显性失血量显著多于早期组（45．9±9．7）mL、晚期组（46．2±9．5）mL，Ps＜0．01；早期组的显性失血量与晚期组差异无统计学意义（P＞0．05）。（2）早期组（140．6±21．1）mL、晚期组（216．7±48．6）mL的隐性失血量显著少于对照组（335．1±60．3）mL，Ps＜0．01；早期组的隐性失血量明显少于晚期组（P＜0．01）。（3）早期组（236．7±42．4）mL、晚期组（344．0±51．5）mL的总红细胞丢失量显著少于对照组（492．8±65．1）mL，Ps＜0．01；早期组的总红细胞丢失量明显少于晚期组（P＜0．01）。结论氨甲环酸能够明显减少初次行髋关节置换术患者的失血量，术前1h使用比术中使用更能明显减少隐性失血量。
목적：탐토불동시간사용안갑배산대초차행관관절치환술환자실혈량적영향。방법장90례초차행관관절치환술적환자안수궤수자표법분위：조기조（30례，안갑배산술전1 h사용）、만기조（30례，안갑배산술중사용）화대조조（30례，불사용）。통계분석환자적현성홍세포주실량、은성홍세포주실량여총홍세포주실량。결과（1）대조조（96．3±21．7）mL적현성실혈량현저다우조기조（45．9±9．7）mL、만기조（46．2±9．5）mL，Ps＜0．01；조기조적현성실혈량여만기조차이무통계학의의（P＞0．05）。（2）조기조（140．6±21．1）mL、만기조（216．7±48．6）mL적은성실혈량현저소우대조조（335．1±60．3）mL，Ps＜0．01；조기조적은성실혈량명현소우만기조（P＜0．01）。（3）조기조（236．7±42．4）mL、만기조（344．0±51．5）mL적총홍세포주실량현저소우대조조（492．8±65．1）mL，Ps＜0．01；조기조적총홍세포주실량명현소우만기조（P＜0．01）。결론안갑배산능구명현감소초차행관관절치환술환자적실혈량，술전1h사용비술중사용경능명현감소은성실혈량。
Objective To discuss the impact of the application timing in tranexamic acid therapy on the blood loss of patients with pre-liminary total hip arthroplasty.Methods Ninety patients with preliminary total hip arthroplasty were assigned into early stage group (n=30,tranexamic acid at preoperative one hour),advanced stage group (n=30,tranexamic acid in operation),and control group (n=30,without tranexamic acid).The visible red blood cell loss,hidden red blood cell loss,and total red blood cell loss were analyzed.Re-sults (1)The visible red blood cell loss in control group (96.3 ±21.7)mL was significantly more than early stage group (45.9 ± 9.7)mL and advanced stage group (46.2 ±9.5)mL,Ps<0.01.There were no significant differences between early stage group and advanced stage group (P>0.05).(2)The hidden red blood cell loss in early stage group (140.6 ±21.1)mL and advanced stage group (216.7 ±48.6)mL were significantly lower than control group (335.1 ±60.3)mL,Ps<0.01.Moreover,hidden red blood cell loss in early stage group was significantly lower than advanced stage group (P<0.01).(3)The total red blood cell loss in early stage group (236.7 ±42.4)mL and advanced stage group (344.0 ±51.5)mL were significantly lower than control group (492.8 ±65.1) mL,Ps<0.01.The total red blood cell loss in early stage group was significantly lower than advanced stage group (P<0.01).Conclu-sions Tranexamic acid reduces the blood loss in preliminary total hip arthroplasty,especially reducing hidden blood loss when used at preoperative one hour.