CAJ | 학술논문

目的：比较氨甲环酸不同给药时间对全髋关节置换( THA)术中及术后失血量的影响。方法选取行单侧THA的患者125例,随机分为5组,每组25例,A组手术结束前10 min给予1 g氨甲环酸静脉滴注；B组分别于手术结束前10 min、术后7 h给予1 g氨甲环酸静脉滴注；C组术前10 min给予1 g氨甲环酸静脉滴注；D组术前10 min给予1 g氨甲环酸,7 h后再给予1 g氨甲环酸静脉滴注；E组为对照组,不给于氨甲环酸及其类似药物。检测血红蛋白、红细胞压积、出血时间、活化部分凝血酶时间等血液学指标,比较5组患者术中及术后失血量差异。结果5组患者术中失血量、术后失血量、术后第1天血红蛋白下降值、围手术期最大血红蛋白减少值、术后绝对失血量差异均具有统计学意义(P<0.05)。 E组5项数值均显著高于其它各组(P<0.05)。 D组术中失血量、围手术期最大血红蛋白减少值、术后绝对失血量分别为(272.9±46.7)ml、(27.8±3.8)g/L、(344.4±61.6)ml,均显著少(小)于A组、B组及E组(P<0.05)。 C组术后失血量、术后第1天血红蛋白下降值,分别为(114.7±32.7)ml、(21.0±3.9)g/L,均显著少(小)于A组、B组及E组(P<0.05)。结论术前10 min给予1 g氨甲环酸,7 h后再给予1 g氨甲环酸静脉滴注在THA围手术期能够最大限度地减少术中及术后出血量。
목적：비교안갑배산불동급약시간대전관관절치환( THA)술중급술후실혈량적영향。방법선취행단측THA적환자125례,수궤분위5조,매조25례,A조수술결속전10 min급여1 g안갑배산정맥적주；B조분별우수술결속전10 min、술후7 h급여1 g안갑배산정맥적주；C조술전10 min급여1 g안갑배산정맥적주；D조술전10 min급여1 g안갑배산,7 h후재급여1 g안갑배산정맥적주；E조위대조조,불급우안갑배산급기유사약물。검측혈홍단백、홍세포압적、출혈시간、활화부분응혈매시간등혈액학지표,비교5조환자술중급술후실혈량차이。결과5조환자술중실혈량、술후실혈량、술후제1천혈홍단백하강치、위수술기최대혈홍단백감소치、술후절대실혈량차이균구유통계학의의(P<0.05)。 E조5항수치균현저고우기타각조(P<0.05)。 D조술중실혈량、위수술기최대혈홍단백감소치、술후절대실혈량분별위(272.9±46.7)ml、(27.8±3.8)g/L、(344.4±61.6)ml,균현저소(소)우A조、B조급E조(P<0.05)。 C조술후실혈량、술후제1천혈홍단백하강치,분별위(114.7±32.7)ml、(21.0±3.9)g/L,균현저소(소)우A조、B조급E조(P<0.05)。결론술전10 min급여1 g안갑배산,7 h후재급여1 g안갑배산정맥적주재THA위수술기능구최대한도지감소술중급술후출혈량。
Objective To compare the different timing of administration of tranexamic acid on total hip arthroplasty and postoperative blood loss. Methods 125 cases undergo total hip arthroplasty were randomly divided into five groups, 25 cases each. Patients in group A received 1g tranexamic acid intravenously 10min before the end of surger-y, group B received 1g tranexamic acid intravenously 10 min before the end of surgery and again in 7 hours after sur-gery, group C received 1g tranexamic acid intravenously 10 min before surgery, group D received 1g tranexamic acid 10 min before surgery and again 7 hours, group E was deemed as control group. Hemoglobin, hematocrit, bleeding time , activated partial thromboplastin time and other heamatological indices were compared in five groups and intraop-erative and postoperative blood loss were compared. Results Intraoperative blood loss, postoperative blood loss, de-creased hemoglobin values after the first day, perioperative hemoglobin decrease the maximum value, absolute amount of blood loss in five groups were statistically significant ( P<0. 05 ) . Group E five aspect values were significantly higher than the other groups (P<0. 05). Intraoperative blood loss, perioperative hemoglobin decrease the maximum value, absolute postoperative blood loss in group D were (272. 9 ± 46. 7) ml, (27. 8 ± 3. 8) g/L, (344. 4 ± 61. 6) ml, and were significantly less than in group A, B group and E group (P<0. 05). While the blood loss, postopera-tive hemoglobin decreased value of the first day in group C were ( 114. 7 ± 32. 7 ) ml, ( 21. 0 ± 3. 9 ) g/L, and were significantly lower than the group A, group B and group E (P<0. 05). Conclusions 1 g tranexamic acid 10 mi-nutes before surgery and 6 hours after the first administration was most effective for the reduction of blood loss during total hip arthroplasty.