CAJ | 학술논문

目的：探讨关节腔内注射氨甲环酸在减少全膝关节置换术后出血的疗效和安全性。方法选取符合纳入标准的患者60例，采用RandA 1.0软件随机平均分为两组。氨甲环酸组于术后关节腔内注射50 ml溶有3.0 g氨甲环酸的生理盐水，夹闭引流管1 h后负压吸引；对照组则术后通过引流管直接向关节腔注入生理盐水50 ml，夹闭引流管1 h后负压吸引。术后三日每天复查患者血常规、凝血指标，并记录每日引流量，术后3～5d行下肢静脉造影，观察血栓发生率。结果氨甲环酸组术后3d总的引流量以及总失血量明显少于对照组。氨甲环酸组输血人数明显小于对照组。两组患者在术后凝血功能、血栓发生率及术后不良事件方面差异无统计学意义。结论全膝关节术后关节腔内注射氨甲环酸可有效减少出血量，并不增加血栓发生概率。
목적：탐토관절강내주사안갑배산재감소전슬관절치환술후출혈적료효화안전성。방법선취부합납입표준적환자60례，채용RandA 1.0연건수궤평균분위량조。안갑배산조우술후관절강내주사50 ml용유3.0 g안갑배산적생리염수，협폐인류관1 h후부압흡인；대조조칙술후통과인류관직접향관절강주입생리염수50 ml，협폐인류관1 h후부압흡인。술후삼일매천복사환자혈상규、응혈지표，병기록매일인류량，술후3～5d행하지정맥조영，관찰혈전발생솔。결과안갑배산조술후3d총적인류량이급총실혈량명현소우대조조。안갑배산조수혈인수명현소우대조조。량조환자재술후응혈공능、혈전발생솔급술후불량사건방면차이무통계학의의。결론전슬관절술후관절강내주사안갑배산가유효감소출혈량，병불증가혈전발생개솔。
Objective To assess the efficacy and safety of tranexamic acid in reducing the blood loss during the primary total knee arthroplasty ( TKA ) by intra-articular injection . Methods A prospective randomized controlled study was carried out , including 60 patients who underwent the primary TKA by the same surgeon team on a standardized technique .Each group instantly accepted 50 ml normal saline intra-articular injection postoperatively with 3.0 g tranexamic acid dissolved in or not .Each patient had negative pressure drainage after the drainage-tube clamped for one hour and received the blood routine examination and the blood coagulation indicator test; their daily drainage in the first three days was recorded postoperatively .The vein angiography of the lower limb was carried out within 3 -5 days to observe the incidence of thrombosis .Results The postoperative drainge and the total blood loss in the tranexamic acid group were significantly less than the control group .The number of the patients accepted transfusion in the tranexamic group was significant smaller than that in the control group .There was no significant difference between the two groups in terms of postoperative coagulation function , thromboembolic events or other adverse events .Conclusion Tranexamic acid is effective in reducing the postoperative blood loss by intra-articular injection in primary TKA without increasing the incidence of thrombosis .