氨甲环酸联合鸡尾酒疗法治疗血友病性膝关节炎的疗效观察.docVIP

氨甲环酸联合鸡尾酒疗法治疗血友病性膝关节炎的疗效观察 　　摘要：目的 观察氨甲环酸联合术中局部浸润麻醉（即鸡尾酒疗法）应用于全膝关节置换治疗血友病性膝关节炎的临床疗效。方法 对7例（11膝）血友病性膝关节炎患者行全膝关节置换术；围术期行凝血因子替代治疗；术中局部浸润麻醉并于手术切口缝合后将氨甲环酸药液自引流管逆向注入关节腔；比较手术前后膝关节HSS各项评分及VAS评分。结果 7例（11膝）术后患者膝关节功能明显改善；手术前后HSS评分及VAS评分比较P0.01差异有统计学意义。结论 氨甲环酸联合鸡尾酒疗法在全膝关节置换治疗血友病性膝关节炎中取得满意的临床效果，提高患者生活质量。 　　关键词：氨甲环酸；鸡尾酒疗法；血友病；全膝关节置换 　　中图分类号：R733 文献标识码：A 文章编号：1006-1959（2017）23-0077-03 　　To Observe the Curative Effect of Tranexamic Acid Combined with Cocktail Therapy in the Treatment of Hemophilic Arthritis of the Knee 　　LUO Guo-dong1，WANG Wen-ji2，HAN Xing-wen2，LIU Yang1，HUANG Jun-gang1 　　（1.the First Clinical Medical School of Lanzhou University，Lanzhou 730000，Gansu，China； 　　2.Department of Orthopedics，First Hospital Affiliated to Lanzhou University，Lanzhou 730000，Gansu，China） 　　Abstract：Objective To observe the clinical efficacy of tranexamic acid combined with local infiltration anesthesia（ie，cocktail therapy）in the treatment of hemophilic knee arthritis with total knee arthroplasty.Methods Total knee arthroplasty was performed in 7 patients（11 knees）hemophilic knee arthritis；perioperative coagulation factor replacement therapy；Intraoperative infiltration of the anesthesia and surgical incision suture after the tranexamic acid from the drainage tube into the joint cavity；compared before and after surgery knee HSS scores and VAS score.Results The function of knee joint was improved in 7 cases（11 knees）.The difference of HSS score and VAS score before and after operation was statistically significant，P0.01.Conclusion Tranexamic acid combined with cocktail therapy in the treatment of hemophilia knee arthritis in patients with knee to achieve satisfactory clinical results，improve patient quality of life. 　　Key words：Tranexamic acid；Cocktail therapy；Hemophilia；Total knee replacement 　　血友病（hemophilia）患者因反?投啻蔚墓亟谀诨?膜出血，积血不能完全吸收，铁沉积于滑膜及关节软骨，刺激滑膜增生、侵蚀软骨，最终出现以关节软骨破坏、关节畸形、挛缩为主要临床特征的血友病性关节炎[1]。血友病性关节炎的进行性发展必然出现关节僵硬、强直及畸形，甚至出现骨性愈合，造成永久性残疾。膝关节是最常见的受累关节（50%），并且以年轻人为主[2]。现末期血友病性膝关节炎患者