静脉与关节腔内应用氨甲环酸减少全膝关节置换失血量的疗效对比.docVIP

静脉与关节腔内应用氨甲环酸减少全膝关节置换失血量的疗效对比 　　【摘要】 目的：比较静脉滴注与关节腔内注射氨甲环酸（TXA）减少全膝关节置换术围手术期失血量的有效性和安全性。方法：选取本院2013年10月-2016年2月符合纳入标准的181例患者，随机均分为三组。静脉滴注组麻醉后以10 mg/kg静脉滴注TXA（≤1.2 g），关节腔内注射组关节腔内注射50 mL溶有1.0 g TXA的0.9%氯化钠溶液，对照组关节腔内注射50 mL 0.9%氯化钠溶液，引流管夹闭2 h后负压吸引。术后前3 d复查患者血常规、凝血指标，并记录每日引流量，术后7 d行下肢静脉彩超，观察血栓发生率。结果：静脉滴注组和关节腔内注射组术后3 d总引流量、总失血量、输血比例均明显少于对照组，比较差异均有统计学意义（P0.05）。结论：静脉滴注或关节腔内注射氨甲环酸均能有效减少全膝关节置换术的失血量，但两者的疗效和安全性无统计学差异。 　　【关键词】 氨甲环酸； 关节置换术； 静脉滴注； 关节腔内注射： 失血 　　Effects of Intravenous Versus Intra-articular Tranexamic Acid on Reducing Blood Loss in Total Knee Arthroplasty of Contrast/YANG Wei-zhen，ZHANG Jian-feng，HU Bao-de，et al.//Medical Innovation of China，2016，13（27）：001-005 　　【Abstract】 Objective：To compare the efficacy and safety of intravenous versus intra-articular Tranexamic Acid on reducing blood loss during the primary total knee arthroplasty（TKA）.Method：From October 2013 to February 2016，181 cases of patients in our hospital were selected，randomly divided into three groups.The intravenous drip group was used intravenous drip TXA（≤1.2 g），intra-articular injection of the injected group was used of 50 mL 0.9% NS with 1.0 g TXA，intra-articular injection of the control group was used of 50 mL 0.9%NS.Each patient had negative pressure drainage after the drainage-tude clamped for 2 hours and received the blood routine examination and the blood coagulation indicator test，their daily drainage in the first three days was recorded postoperatively.The vein angiography of the lower limb was carried out within 7 days to observe the incidence of thrombosis.Result：Compared with the postoperative drainage，the total blood loss in both intravenous and intra-articular tranexamic aid，the intravenous drip group and the injected groups were less than that of the control group，the differences were statistically significant（P0.05）.Conclusion：Both intravenous and intra-articular tranexamic aid are effective in reducing the postoperative blood loss in primary TKA without increasing the inci