重庆医学
重慶醫學
중경의학
Chongqing Medicine
2015年
31期
4367-4369,4372
,共4页
及松洁%周一新%李玉军%徐辉
及鬆潔%週一新%李玉軍%徐輝
급송길%주일신%리옥군%서휘
氨甲环酸%全膝关节置换术%失血 ,手术%治疗结果
氨甲環痠%全膝關節置換術%失血 ,手術%治療結果
안갑배산%전슬관절치환술%실혈 ,수술%치료결과
tranexamic acid%arthroplasty,replacement,knee%blood loss,surgical%treatment outcome
目的：探讨单侧全膝关节置换（TKA）术中应用氨甲环酸的不同给药方法对出血量的影响。方法对2013年6月至2014年5月符合标准的120例初次单侧TKA术患者进行研究。其中男33例，女97例；年龄31～81岁，平均（65±9）岁。将患者分为静脉使用氨甲环酸组（V组）、局部使用氨甲环酸组（T组）、冲洗液使用氨甲环酸组（I组）以及未使用氨甲环酸组（L组），每组30例。4组患者的年龄、性别、体质量指数、疾病诊断、手术时间、术前血红蛋白、术前红细胞比积等参数差异均无统计学意义（P＞0．05）。记录术后失红细胞量和输红细胞量，观察患者是否出现下肢深静脉栓塞症状。组间比较采用单因素方差分析。结果V组总红细胞丢失量为（368±95）mL，T组（407±118）mL，少于对照组（509±96）mL，差异有统计学意义（P＜0．05）。I组总红细胞丢失量为（491±122）mL，与C组比较差异无统计学意义（P＝0．924）。V组隐性失血量最少，T组可见失血量最少。4组均未出现深静脉栓塞、感染等并发症。结论TKA术中静脉和局部使用氨甲环酸均能明显减少术后出血量。冲洗液中加入氨甲环酸不能有效减少出血量。
目的：探討單側全膝關節置換（TKA）術中應用氨甲環痠的不同給藥方法對齣血量的影響。方法對2013年6月至2014年5月符閤標準的120例初次單側TKA術患者進行研究。其中男33例，女97例；年齡31～81歲，平均（65±9）歲。將患者分為靜脈使用氨甲環痠組（V組）、跼部使用氨甲環痠組（T組）、遲洗液使用氨甲環痠組（I組）以及未使用氨甲環痠組（L組），每組30例。4組患者的年齡、性彆、體質量指數、疾病診斷、手術時間、術前血紅蛋白、術前紅細胞比積等參數差異均無統計學意義（P＞0．05）。記錄術後失紅細胞量和輸紅細胞量，觀察患者是否齣現下肢深靜脈栓塞癥狀。組間比較採用單因素方差分析。結果V組總紅細胞丟失量為（368±95）mL，T組（407±118）mL，少于對照組（509±96）mL，差異有統計學意義（P＜0．05）。I組總紅細胞丟失量為（491±122）mL，與C組比較差異無統計學意義（P＝0．924）。V組隱性失血量最少，T組可見失血量最少。4組均未齣現深靜脈栓塞、感染等併髮癥。結論TKA術中靜脈和跼部使用氨甲環痠均能明顯減少術後齣血量。遲洗液中加入氨甲環痠不能有效減少齣血量。
목적：탐토단측전슬관절치환（TKA）술중응용안갑배산적불동급약방법대출혈량적영향。방법대2013년6월지2014년5월부합표준적120례초차단측TKA술환자진행연구。기중남33례，녀97례；년령31～81세，평균（65±9）세。장환자분위정맥사용안갑배산조（V조）、국부사용안갑배산조（T조）、충세액사용안갑배산조（I조）이급미사용안갑배산조（L조），매조30례。4조환자적년령、성별、체질량지수、질병진단、수술시간、술전혈홍단백、술전홍세포비적등삼수차이균무통계학의의（P＞0．05）。기록술후실홍세포량화수홍세포량，관찰환자시부출현하지심정맥전새증상。조간비교채용단인소방차분석。결과V조총홍세포주실량위（368±95）mL，T조（407±118）mL，소우대조조（509±96）mL，차이유통계학의의（P＜0．05）。I조총홍세포주실량위（491±122）mL，여C조비교차이무통계학의의（P＝0．924）。V조은성실혈량최소，T조가견실혈량최소。4조균미출현심정맥전새、감염등병발증。결론TKA술중정맥화국부사용안갑배산균능명현감소술후출혈량。충세액중가입안갑배산불능유효감소출혈량。
Objective To investigate the effect of the application of tranexamic acid in unilateral total knee arthroplasty (TKA)with different methods .Methods Totally 120 cases of primary unilateral TKA patients admitted from June 2013 to May 2012 were studied ,including 33 males and 97 females ,with the average age of (65 ± 9) years (31 to 81 years) .Patients were divided into intravenous tranexamic acid group (group V ) ,topical tranexamic acid group (group T ) and irrigation using tranexamic acid group (group I) ,and control group (group C) .There were 30 cases in each group .Four groups of patients had no differences in age ,gender ,body mass index and disease diagnosis ,operative time ,preoperative hemoglobin ,preoperative hematocrit differences sta‐tistically(P>0 .05) .Postoperative blood loss and blood transfusion were observed .Groups were compared using one‐way ANOVA analysis .Results The total blood loss of group V was (368 ± 95)mL ,total blood loss of group T was (407 ± 118)mL ,both were less than the control group (509 ± 96)mL ,the difference was statistically significant (P<0 .05) .The differences between the blood loss of group I (491 ± 122) mL and the control group was not statistically significant (P=0 .924) .Group V showed the least a‐mount of hidden blood loss .Group T showed the least amount of visible blood loss .There were not deep vein thrombosis ,infections and other complications in any groups .Conclusion Intravenous and topical application of tranexamic acid can significantly reduce postoperative blood loss in TKA .Irrigation with tranexamic acid can not reduce the blood loss effectively .
