CAJ | 학술논문

目的：探讨不同剂量氨甲环酸( TA)对初次全髋关节置换术( THA)围手术期失血量的影响。方法160例行初次单侧THA的股骨颈骨折患者分为4组：TA 10 mg/kg组、TA 15 mg/kg组、TA 20 mg/kg组、对照组,每组各40例。手术开始前15 min,TA组将TA分别按10、15、20 mg/kg的剂量稀释于250 ml生理盐水后静滴；对照组予生理盐水250 ml静滴。比较各组围手术期总失血量、显性失血量、隐性失血量、异体输血量和静脉血栓发生率。结果 TA 10 mg/kg组、15 mg/kg组、20 mg/kg组围手术期总失血量、显性失血量、隐性失血量、异体输血量与对照组相比差异均有统计学意义( P<0．05)； TA 15 mg/kg组、TA 20 mg/kg组与TA 10 mg/kg组相比,总失血量、隐性失血量和异体输血量差异均有统计学意义(P<0．05)。各组深静脉血栓(DVT)发生率比较差异均无统计学意义(P>0．05)。结论初次THA术前静脉使用TA能明显降低患者围手术期失血量和异体输血量,剂量15 mg/kg、20 mg/kg更为有效。
목적：탐토불동제량안갑배산( TA)대초차전관관절치환술( THA)위수술기실혈량적영향。방법160례행초차단측THA적고골경골절환자분위4조：TA 10 mg/kg조、TA 15 mg/kg조、TA 20 mg/kg조、대조조,매조각40례。수술개시전15 min,TA조장TA분별안10、15、20 mg/kg적제량희석우250 ml생리염수후정적；대조조여생리염수250 ml정적。비교각조위수술기총실혈량、현성실혈량、은성실혈량、이체수혈량화정맥혈전발생솔。결과 TA 10 mg/kg조、15 mg/kg조、20 mg/kg조위수술기총실혈량、현성실혈량、은성실혈량、이체수혈량여대조조상비차이균유통계학의의( P<0．05)； TA 15 mg/kg조、TA 20 mg/kg조여TA 10 mg/kg조상비,총실혈량、은성실혈량화이체수혈량차이균유통계학의의(P<0．05)。각조심정맥혈전(DVT)발생솔비교차이균무통계학의의(P>0．05)。결론초차THA술전정맥사용TA능명현강저환자위수술기실혈량화이체수혈량,제량15 mg/kg、20 mg/kg경위유효。
Objective To investigate the efficacy of different doses of tranexamic acid ( TA ) use for perioperative blood loss control primary unilateral total hip arthroplasty(THA). Methods 160 patients underwent primary THA due to femoral neck fracture were randomly divided into TA 10 mg/kg group, TA 15 mg/kg group, TA 20 mg/kg group and the control group with 40 cases in each group. In the TA group, 10 mg/kg,15 mg/kg or 20 mg/kg TA with 250ml normal saline was infused intravenously within 15 minutes before skin incision, while an equal volume of nor-mal saline was given instead in the control group. Total blood loss, visible blood loss, hidden blood loss, blood trans-fusion volume, blood transfusion rate, and the rate of deep vein thrombosis of different groups were compared. Re-sults In TA 10 mg/kg group, TA 15 mg/kg group or TA 20 mg/kg group, the total blood loss, visible blood loss, hidden blood loss and blood transfusion volume were all less than those in the control group. The difference had statis-tical significance(P<0. 05). Compared with TA 10 mg/kg group, the total blood loss, hidden blood loss and blood transfusion volume were significantly reduced in TA 15 mg/kg group or TA 20 mg/kg group(P<0. 05). While the incidence of deep venous thrombosis had no statistically significant differences among each group(P>0. 05). Con-clusions Intravenous infusion of TA within 15 minutes before skin incision reduces the perioperative blood loss and blood transfusion volume in primary unilateral THA significantly. Compared with 10 mg/kg, 15 mg/kg or 20 mg/kg TA gains more advantage of less perioperative blood loss.