天津医药

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氨甲环酸关节腔内注射和自体血回吸收器对TKA术后失血的影响

王磊   

  1. 天津市人民医院关节外科
  • 收稿日期:2013-04-15 修回日期:2013-05-11 出版日期:2013-08-15 发布日期:2013-08-15
  • 通讯作者: 王磊

WANG Lei   

  1. Department of Orthopedics, People’s Hospital of Tianji
  • Received:2013-04-15 Revised:2013-05-11 Published:2013-08-15 Online:2013-08-15
  • Contact: WANG Lei

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摘要： 【摘要】 目的 明确单剂量氨甲环酸（TXA）关节腔内注射和自体血回吸收器应用对全膝关节置换（TKA）术后失血的影响。 方法 回顾分析采用 TKA 治疗的内翻型膝关节骨性关节炎患者 124例（124膝）， 男 24例， 女 100例， 平均年龄（65.03±6.84）岁。 根据 TKA 控制术后失血的方法将所有患者分为 TXA 注射组（实验组， 49 例）和自体血回吸收器应用组（对照组， 75 例）。 分析 TKA 术后血常规的变化、失血量和输血情况。 结果 术后 7 d 实验组输血率为10.20%（5/49）， 对照组为 17.33%（13/75）， 差异无统计学意义（P＞ 0.05）。 RBC、Hb、HCT在组间、时间和交互效应差异
均有统计学意义（均 P＜ 0.01）。 术后 1、3、7 d， 实验组 RBC、Hb、HCT均高于对照组（均 P＜ 0.05）。 术后 1、3 d 实验组总失血量小于对照组， 术后 7 d， 2 组失血量比较差异无统计学意义（P＞ 0.05）。 结论 关节腔内单剂 TXA 注射对于TKA术后止血安全有效。


关键词: 膝关节, 人工, 关节成形术, 置换, 膝, 氨甲环酸, 输血, 自体

Abstract: Objective  To compare the efficiency of tranexamic acid single dose intraarticular injection and autologous transfusion drain on the blood loss post total knee arthroplasty (TKA). Methods  124 patients (124 knees) with varus knee osteoarthritis performed TKA were retrospectively analyzed, 24 males and 100 females, the mean age was 65.03 years. Due to the blood loss control methods, two groups were divided as TXA application group (test group, n = 49) and autologous transfusion drain group (control group, n =75). The blood loss and blood transfusion characters were analyzed. Results   The allogeneic blood transfusion ratio 7 days post TKA surgery was 10.20% (5/49) in the test group and 17.33% (13/75) in the control group group (P＞0.05). The RBC, Hb, HCT all had statistics difference according to test period, between groups and effects of interaction in the two groups(P＜0.05). Significant difference was found when the RBC, Hb and HCT were compared at the 1,3,7 day post TKA between the two groups (P＜0.05), while the total blood loss post TKA showed no statistic difference (P＞0.05). Conclusion   Compared with autologous transfusion drain, single dose intraarticular injection of tranexamic acid 500 mg can significantly improve the levels of RBC, Hb and HCT at the day 1, 3 and 7 after TKA. However, the blood transfusion ratio, total blood loss and Hb decline in 7 days post TKA showed no significant difference in the two groups.

Key words: knee prosthesis, arthroplasty, replacement, knee, tranexamic acid, blood transfusion, autologous, 自体