关节腔内注射氨甲环酸联合引流管夹闭对TKA围手术期失血量的影响.docVIP

精品论文 参考文献 关节腔内注射氨甲环酸联合引流管夹闭对TKA围手术期失血量的影响 1潍坊市人民医院 山东潍坊 261041；2潍坊医学院 山东潍坊 261053 摘要：目的 研究关节腔注射氨甲环酸联合引流管夹闭3h对全膝关节置换术（Total knee arthroplasty，TKA）围手术期总失血量、隐性失血量、引流量的影响，寻找减少TKA围手术期围手术期失血量的最佳方法。方法 选取本院骨关节外科2013年9至2015年3月初次接受单侧TKA患者120例，按入院顺序随机分成A、B、C、D4组，分别为关节腔内注射50ml氨甲环酸（含氨甲环酸2000mg)联合引流管夹闭3h（A组）、关节腔内注射等量氨甲环酸联合引流管持续开放（B组）、关节腔内注射等量生理盐水联合引流管暂时夹闭3h（C组）、关节腔内注射等量生理盐水联合引流管持续开放（D组），每组各30例。比较各组总失血量、隐性失血量、引流量、术后并发症情况。结果 A组围手术期总失血量、隐性失血量、引流量均低于其他三组（P＜0.05）；并发症方面四 组没有统计学差异。结论 关节腔注射氨甲环酸联合引流管夹闭3h能够有效减少TKA围手术期总失血量、隐性失血量、引流量，且不增加并发症。 关键词：氨甲环酸；引流管夹闭；全膝关节置换术；失血；引流量 [Abstractive] Objective To explore effectiveness of topical tranexamic acid combined with temporary clamping of drainage on reducing blood loss in total knee arthroplasty（TKA)and find best way to reduce the blood loss.Method 120 Patients who received primary unilateral total knee arthroplasty in joint surgery of our hospital from September of 2013 to March of 2015，were randomly divided into group A、B、C and D，with 30 patients each.Patients in group A received intra-articular injection of 50ml tranexamic acid（contain 2000mg tranexamic acid) group with clamping the drainage tube for 3-hour；patients in group B received intra-articular injection of tranexamic acid group with the drainage tube maintained open；patients in group C received the same volume of physiological saline injection with clamping the drainage tube for 3-hour；patients in group D received the same volume of physiological saline injection with the drainage tube maintained open.Then the dominant blood loss，hidden blood loss and postoperative complications of each group were compared，accompanied by observing clinic symptoms of pulmonary embolism and lower limb DVT.And Doppler ultrasound examine on lower extremity would stand by if necessary.Result Dorminant and hidden blood loss of patients from group A was apparently lower than that of patients from B，C and D group，and difference was significant（P＜0.05）.No statistically significant difference was found in p