中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2015年
6期
16-18
,共3页
朱云森%江敞%李俊
硃雲森%江敞%李俊
주운삼%강창%리준
失血,手术%氨甲环酸%髋骨折%转子间骨折%骨折固定术,髓内%股骨近端防旋髓内钉%静脉血栓形成%治疗,临床研究性
失血,手術%氨甲環痠%髖骨摺%轉子間骨摺%骨摺固定術,髓內%股骨近耑防鏇髓內釘%靜脈血栓形成%治療,臨床研究性
실혈,수술%안갑배산%관골절%전자간골절%골절고정술,수내%고골근단방선수내정%정맥혈전형성%치료,림상연구성
blood loss,surgical%tranexamic acid%hip fractures%intertrochanteric fractures%fracture fixation,intramedullary%proximal femo-ral nail antirotation%venous thrombosis%therapies,investigational
目的：探讨氨甲环酸对老年股骨转子间骨折髓内固定术围手术期隐性失血的影响。方法：将83例符合要求的老年股骨转子间骨折患者随机分为2组，氨甲环酸组43例、常规组40例。所有患者的手术均由同一组医生完成，均采用股骨近端防旋髓内钉内固定治疗，氨甲环酸组患者分别于入院当天和手术开始前静脉滴注氨甲环酸（10 mg·kg －1）1次。测定2组患者的失血量，并观察术后深静脉血栓形成情况。结果：2组患者手术时间、显性失血量比较，组间差异均无统计学意义[（32．58±5．12）min，（31．90±8．73）min，t ＝0．437，P ＝0．110；（89．67±15．24）mL，（97．60±14．65）mL，t ＝2．410，P ＝0．794]；氨甲环酸组术前及术后隐性失血量均少于常规组[（84．91±13．66）mL，（154．08±26．99）mL，t ＝14．883，P ＝0．000；（158．23±30．16）mL，（286．15±59．61）mL，t ＝12．460，P ＝0．013]。2组均未出现深静脉血栓形成病例。结论：应用氨甲环酸可有效减少老年股骨转子间骨折髓内固定术围手术期隐性失血，而且具有较高的安全性。
目的：探討氨甲環痠對老年股骨轉子間骨摺髓內固定術圍手術期隱性失血的影響。方法：將83例符閤要求的老年股骨轉子間骨摺患者隨機分為2組，氨甲環痠組43例、常規組40例。所有患者的手術均由同一組醫生完成，均採用股骨近耑防鏇髓內釘內固定治療，氨甲環痠組患者分彆于入院噹天和手術開始前靜脈滴註氨甲環痠（10 mg·kg －1）1次。測定2組患者的失血量，併觀察術後深靜脈血栓形成情況。結果：2組患者手術時間、顯性失血量比較，組間差異均無統計學意義[（32．58±5．12）min，（31．90±8．73）min，t ＝0．437，P ＝0．110；（89．67±15．24）mL，（97．60±14．65）mL，t ＝2．410，P ＝0．794]；氨甲環痠組術前及術後隱性失血量均少于常規組[（84．91±13．66）mL，（154．08±26．99）mL，t ＝14．883，P ＝0．000；（158．23±30．16）mL，（286．15±59．61）mL，t ＝12．460，P ＝0．013]。2組均未齣現深靜脈血栓形成病例。結論：應用氨甲環痠可有效減少老年股骨轉子間骨摺髓內固定術圍手術期隱性失血，而且具有較高的安全性。
목적：탐토안갑배산대노년고골전자간골절수내고정술위수술기은성실혈적영향。방법：장83례부합요구적노년고골전자간골절환자수궤분위2조，안갑배산조43례、상규조40례。소유환자적수술균유동일조의생완성，균채용고골근단방선수내정내고정치료，안갑배산조환자분별우입원당천화수술개시전정맥적주안갑배산（10 mg·kg －1）1차。측정2조환자적실혈량，병관찰술후심정맥혈전형성정황。결과：2조환자수술시간、현성실혈량비교，조간차이균무통계학의의[（32．58±5．12）min，（31．90±8．73）min，t ＝0．437，P ＝0．110；（89．67±15．24）mL，（97．60±14．65）mL，t ＝2．410，P ＝0．794]；안갑배산조술전급술후은성실혈량균소우상규조[（84．91±13．66）mL，（154．08±26．99）mL，t ＝14．883，P ＝0．000；（158．23±30．16）mL，（286．15±59．61）mL，t ＝12．460，P ＝0．013]。2조균미출현심정맥혈전형성병례。결론：응용안갑배산가유효감소노년고골전자간골절수내고정술위수술기은성실혈，이차구유교고적안전성。
Objective:To explore the effect of tranexamic acid on perioperative hidden blood loss in aged patients receiving intramedul-lary fixation for treatment of intertrochanteric fractures.Methods:Eighty-three aged patients with intertrochanteric fractures enrolled in the study were randomly divided into tranexamic acid group(43 cases)and conventional group(40 cases).All patients were treated with proxi-mal femoral nail antirotation(PFNA)internal fixation by the same group of surgeons.Intravenous drip infusions of tranexamic acid(10 mg/kg) were performed on patients in tranexamic acid group on the day of admission and before the start of the surgery respectively.Then the blood loss were measured and compared between the 2 groups and the postoperative deep vein thrombosis were also recorded.Results:There was no statistical difference in operation time and dominant blood loss between the 2 groups(32.58 +/-5.12 vs 31.90 +/-8.73 min,t =0.437,P =0.110;89.67 +/-15.24 vs 97.60 +/-14.65 mL,t =2.410,P =0.794),while hidden blood loss was less in the tranexamic acid group compared to the conventional group before and after the operation(84.91 +/-13.66 vs 154.08 +/-26.99 mL,t =14.883,P =0.000;158.23 +/-30.16 vs 286.15 +/-59.61 mL,t =12.460,P =0.013).Deep venous thrombosis was not found in both of the 2 groups.Conclusion:Application of tranexamic acid can effectively reduce perioperative hidden blood loss in aged patients receiving intr-amedullary fixation for treatment of intertrochanteric fractures,meanwhile it has high safety.
