CAJ | 학술논문

目的：探讨单侧初次全膝关节置换术中给予不同剂量氨甲环酸的有效性。方法2014年1—9月之间拟行初次单侧人工全膝关节置换术的骨关节炎90例,随机分为3组,每组30例：关闭切口前静脉滴注生理盐水(A组)；关闭切口前静脉滴注氨甲环酸10 mg/ kg(B 组)；关闭切口前静脉滴注氨甲环酸15 mg/ kg(C 组)。比较3组的术后24 h 引流量、总失血量、显性失血量、隐性失血量、输血率、术后深静脉血栓和肺栓塞发生率。结果3组手术时间和术中出血量、输血率的差异无统计学意义(P >0．05)。 B、C 组术后引流量明显低于 A 组(P <0．05),B、C 组术后血红蛋白水平均高于 A 组(P <0．05),B、C 组的总失血量、显性失血量低于 A 组(P <0．05),C 组隐性失血量显著低于A、B 组(P <0．05)。3组术后均无深静脉血栓及肺梗死发生。结论全膝关节置换术中闭合切口前静滴氨甲环酸能有效减少术后引流量、总失血量、显性失血量,提高术后血红蛋白水平,静滴15 mg/ kg 的氨甲环酸能进一步减少隐性失血。
목적：탐토단측초차전슬관절치환술중급여불동제량안갑배산적유효성。방법2014년1—9월지간의행초차단측인공전슬관절치환술적골관절염90례,수궤분위3조,매조30례：관폐절구전정맥적주생리염수(A조)；관폐절구전정맥적주안갑배산10 mg/ kg(B 조)；관폐절구전정맥적주안갑배산15 mg/ kg(C 조)。비교3조적술후24 h 인류량、총실혈량、현성실혈량、은성실혈량、수혈솔、술후심정맥혈전화폐전새발생솔。결과3조수술시간화술중출혈량、수혈솔적차이무통계학의의(P >0．05)。 B、C 조술후인류량명현저우 A 조(P <0．05),B、C 조술후혈홍단백수평균고우 A 조(P <0．05),B、C 조적총실혈량、현성실혈량저우 A 조(P <0．05),C 조은성실혈량현저저우A、B 조(P <0．05)。3조술후균무심정맥혈전급폐경사발생。결론전슬관절치환술중폐합절구전정적안갑배산능유효감소술후인류량、총실혈량、현성실혈량,제고술후혈홍단백수평,정적15 mg/ kg 적안갑배산능진일보감소은성실혈。
Objective To explore the effectiveness of different dosages of Tranexamic Acid (TXA) in applica-tion of unilateral primary total knee arthroplasty (TKA). Methods A total of 90 patients with knee osteoarthritis, un-dergoing unilateral primary TKA from January to September 2014 were randomly divided into three groups (n = 30 for each group). Patients in group A received physiological saline via fast intravenous infusion before closing the incision;patients in group B received 10 mg/ kg TXA via fast intravenous infusion before closing the incision; patients in group C received 15 mg/ kg TXA via fast intravenous infusion before closing the incision. The draining volume within postoperative 24 h, total blood loss, external blood loss, hidden blood loss, transfusion rate and incidence rates of postoperative deep vein thrombosis rate and pulmonary embolism were compared in the three groups. Results There were no significant differences in operation time, intraoperative bleeding volume and transfusion rate in the three groups (P < 0. 05). Com-pared with those in group A, postoperative draining volumes were significantly reduced (P < 0. 05), and postoperative hemoglobin levels were significantly increased (P < 0. 05), and the values of total blood loss and external blood loss were significantly decreased in group B and C (P < 0. 05). The value of hidden blood loss in group C was significantly de-creased compared with those in group A and B (P < 0. 05). No postoperative deep vein thrombosis or pulmonary embol-ism was found in the three groups. Conclusion TXA intravenous infusion before closing the incision in application of TKA can effectively reduce the volumes of postoperative draining volume, total blood loss and external blood loss and in-crease the postoperative hemoglobin level, and 15mg/ kg of TXA intravenous infusion is more effective in reducing hidden blood loss.