氨甲环酸在人工全髋关节置换术后患者中的应用效果
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摘要
目的探讨氨甲环酸在人工全髋关节置换术后患者中的应用效果。方法选取2014年4～12月在我院行人工全髋关节置换术的80例患者作为研究对象,按照随机分组软件分为实验组和对照组,每组各40例。实验组采取在术中缝合切口后通过引流管将氨甲环酸注入到伤口内部的方法 ,对照组不予以注射氨甲环酸。比较两组患者手术前后的血红蛋白水平,术中失血量、术后失血量、输血量及不良反应发生情况。结果两组患者术前24 h的血红蛋白水平比较,差异无统计学意义(P>0.05);两组患者术后24、48 h的血红蛋白水平均低于术前24 h,差异有统计学意义(P<0.05);实验组患者术后24、48 h的血红蛋白水平均高于对照组,差异有统计学意义(P<0.05);两组患者的术中失血量比较,差异无统计学意义(P>0.05);实验组患者的术后可见出血量与输血量均少于对照组,差异有统计学意义(P<0.05);两组患者均未发生不良反应。结论在人工全髋关节置换术中应用氨甲环酸,能显著减缓血红蛋白水平的丢失,减少患者的术后可见出血量及输血量,应用安全性高,对促进患者术后机体的尽快康复有着积极意义。
Objective To investigate the application effect of Tranexamic Acid in patients after total hip arthroplasty.Methods Eighty patients who underwent total hip arthroplasty in our hospital from April to December 2014 were selected as the research objects, they were divided into experimental group and control group, 40 cases in each group according to the randomized grouping software. Tranexamic Acid was injected into the wound by drainage tube after suturing the incision in the experimental group, while Tranexamic Acid was not injected into the control group. The levels of hemoglobin before and after operation, intraoperative blood loss, postoperative blood loss, blood transfusion and adverse reactions were compared between the two groups. Results There was no significant difference in the level of hemoglobin 24 hours before operation between the two groups(P>0.05). The levels of hemoglobin at 24 and 48 hours after operation in both groups were lower than those at 24 hours before operation, the differences were statistically significant(P<0.05). The level of hemoglobin in the experimental group was higher than that in the control group at 24 and 48 hours after operation, the differences were statistically significant(P<0.05). There was no significant difference in intraoperative blood loss between the two groups(P>0.05). The amount of bleeding and blood transfusion in the experimental group were less than those in the control group, the difference was statistically significant(P<0.05). There were no adverse reactions in both groups. Conclusion The application of Tranexamic Acid in total hip arthroplasty can significantly slow down the loss of hemoglobin level, reduce the amount of bleeding and blood transfusion after operation, and has high safety. It has a positive significance for promoting the recovery of patients as soon as possible.
Objective To investigate the application effect of Tranexamic Acid in patients after total hip arthroplasty.Methods Eighty patients who underwent total hip arthroplasty in our hospital from April to December 2014 were selected as the research objects, they were divided into experimental group and control group, 40 cases in each group according to the randomized grouping software. Tranexamic Acid was injected into the wound by drainage tube after suturing the incision in the experimental group, while Tranexamic Acid was not injected into the control group. The levels of hemoglobin before and after operation, intraoperative blood loss, postoperative blood loss, blood transfusion and adverse reactions were compared between the two groups. Results There was no significant difference in the level of hemoglobin 24 hours before operation between the two groups(P>0.05). The levels of hemoglobin at 24 and 48 hours after operation in both groups were lower than those at 24 hours before operation, the differences were statistically significant(P<0.05). The level of hemoglobin in the experimental group was higher than that in the control group at 24 and 48 hours after operation, the differences were statistically significant(P<0.05). There was no significant difference in intraoperative blood loss between the two groups(P>0.05). The amount of bleeding and blood transfusion in the experimental group were less than those in the control group, the difference was statistically significant(P<0.05). There were no adverse reactions in both groups. Conclusion The application of Tranexamic Acid in total hip arthroplasty can significantly slow down the loss of hemoglobin level, reduce the amount of bleeding and blood transfusion after operation, and has high safety. It has a positive significance for promoting the recovery of patients as soon as possible.
引文
[1]柴星宇,苏长征,庞涛,等.全膝关节置换后静脉与局部应用氨甲环酸对失血量的影响[J].中国组织工程研究,2015,13(35):5604-5609.
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[3]孙松涛,肖涟波.术后追加应用氨甲环酸对类风湿性关节炎全膝关节置换术后失血量的影响[J].广西医学,2018,40(9):1012-1016.
[4]李晓声,李晶,陈铁柱,等.氨甲环酸局部注射对初次单侧全膝关节置换术后失血量的影响[J].中国现代医学杂志,2017,27(8):66-70.
[5]张权,孙立,杨先腾,等.关节腔内使用氨甲环酸对全膝关节置换术后失血量的影响及安全性评估[J].中华创伤骨科杂志,2015,17(5):395-398.
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[7]赵光辉,马建兵,段宏昊,等.氨甲环酸联合给药对TKA术后失血量的有效性和安全性研究[J].实用骨科杂志,2015,24(8):691-694.
[8]席少华,周朝波,赵桂林,等.氨甲环酸局部应用结合术后临时夹闭引流管对全膝关节置换术后失血量的影响[J].中国医药,2015,10(4):543-545.
[9]张晓冬,李蕾,王国柱,等.氨甲环酸应用方式对全膝关节置换患者术后失血量的影响[J].中国骨与关节杂志,2016,5(12):896-899.
[10]宝音,张红英,段丽军,等.氨甲环酸关节内灌注对全膝关节置换术后失血量的影响[J].解放军医学院学报,2016,37(6):582-585.
[11]张楠,翁润民.术中应用氨甲环酸对全膝关节置换术后失血量的影响及安全性分析[J].创伤外科杂志,2017,19(8):583-586.
[12]李大坤,高忠,邢刚,等.局部应用与静脉注射氨甲环酸减少全髋关节置换术术后失血量有效性与安全性的研究[J].中国骨与关节损伤杂志,2016,31(8):843-844.
[13]张家恺,梁培雄,刘忠,等.局部使用氨甲环酸联合肾上腺素对全髋关节置换术后失血量的影响[J].临床骨科杂志,2017,20(1):58-60,61.
[14]罗太行,古霖,罗世富,等.联合应用氨甲环酸对TKA术后失血量疗效观察[J].养生保健指南,2018,30(19):314-315.
[15]魏立,邱宇,孙亢,等.全膝关节置换术中局部应用氨甲环酸对术后失血量的影响[J].中国医刊,2017,52(4):60-62.
[2]包洪波,田晓滨,孙立,等.局部使用不同浓度氨甲环酸对全膝关节置换术后失血量影响的临床随机对照研究[J].中华创伤骨科杂志,2016,18(5):407-411.
[3]孙松涛,肖涟波.术后追加应用氨甲环酸对类风湿性关节炎全膝关节置换术后失血量的影响[J].广西医学,2018,40(9):1012-1016.
[4]李晓声,李晶,陈铁柱,等.氨甲环酸局部注射对初次单侧全膝关节置换术后失血量的影响[J].中国现代医学杂志,2017,27(8):66-70.
[5]张权,孙立,杨先腾,等.关节腔内使用氨甲环酸对全膝关节置换术后失血量的影响及安全性评估[J].中华创伤骨科杂志,2015,17(5):395-398.
[6]鲁超,侯卫坤,杨治,等.氨甲环酸对人工全膝关节置换术后失血量的影响分析[J].河北医药,2016,38(17):2569-2571.
[7]赵光辉,马建兵,段宏昊,等.氨甲环酸联合给药对TKA术后失血量的有效性和安全性研究[J].实用骨科杂志,2015,24(8):691-694.
[8]席少华,周朝波,赵桂林,等.氨甲环酸局部应用结合术后临时夹闭引流管对全膝关节置换术后失血量的影响[J].中国医药,2015,10(4):543-545.
[9]张晓冬,李蕾,王国柱,等.氨甲环酸应用方式对全膝关节置换患者术后失血量的影响[J].中国骨与关节杂志,2016,5(12):896-899.
[10]宝音,张红英,段丽军,等.氨甲环酸关节内灌注对全膝关节置换术后失血量的影响[J].解放军医学院学报,2016,37(6):582-585.
[11]张楠,翁润民.术中应用氨甲环酸对全膝关节置换术后失血量的影响及安全性分析[J].创伤外科杂志,2017,19(8):583-586.
[12]李大坤,高忠,邢刚,等.局部应用与静脉注射氨甲环酸减少全髋关节置换术术后失血量有效性与安全性的研究[J].中国骨与关节损伤杂志,2016,31(8):843-844.
[13]张家恺,梁培雄,刘忠,等.局部使用氨甲环酸联合肾上腺素对全髋关节置换术后失血量的影响[J].临床骨科杂志,2017,20(1):58-60,61.
[14]罗太行,古霖,罗世富,等.联合应用氨甲环酸对TKA术后失血量疗效观察[J].养生保健指南,2018,30(19):314-315.
[15]魏立,邱宇,孙亢,等.全膝关节置换术中局部应用氨甲环酸对术后失血量的影响[J].中国医刊,2017,52(4):60-62.