解放军医药杂志2016，Vol.28Issue(7)：86-91,6.DOI:10.3969/j.issn.2095-140X.2016.07.023
氨甲环酸不同给药方案对全髋关节置换类风湿关节炎患者预后的影响
Effects of Different Dosage Medications of Tranexamic Acid on Prognoses of Patients with Rheumatoid Arthritis Undergoing Total Hip Replacement
摘要
Abstract
Objective To investigate effect of difference dosage medications of Tranexamic Acid on prognoses of patients with rheumatoid arthritis (RA) undergoing total hip arthroplasty (THA). Methods Clinical data of 156 RA patients undergoing THA during April 2012 and January 2015 was retrospectively analyzed, and all the patients were di-vided into study group I (n=52), study group Ⅱ (n=56) and control group (n=48) according to Tranexamic Acid dosage medications. Study group I was injected with Tranexamic Acid intravenously 30 min before operation and 6 h after operation;study group Ⅱ received Tranexamic Acid by intravenous drips 30 min before operation;control group was in-jected with normal saline intravenously 30 min before operation and 6 h after operation. In three groups, perioperative conditions of blood loss were observed, preoperative and postoperative hemoglobin ( Hb) levels and Hb maximum de-crease value during operation were recorded;different values of surgical side body circumference and changes of coagula-tion indexes before and after operation were analyzed, and incidence rates of deep venous thrombosis ( DVT) within post-operative 2 weeks were recorded. Results Values of perioperative and postoperative blood loss volume, blood transfu-sion rate and blood transfusion volume in study group I andⅡwere less than those in control group, and values of postop-erative blood loss volume, blood transfusion rate and blood transfusion volume in study group I were less than those in study group Ⅱ (P<0. 05). Loss values of dominant and recessive erythrocytes in study group I and Ⅱ were less than those in control group, and the values in study group I were less than those in study group Ⅱ (P<0. 05). Hb levels 24 h after operation were significantly lower than those before operation in three groups, and the levels in study group I and Ⅱ were higher than that in control group, and the level in study group I was higher than that in study groupⅡ( P<0. 05);Hb maximum decrease values during operation in study group I andⅡwere less than that in control group, and the value in study group I was less than that in study group Ⅱ(P<0. 05). In three groups, prothrombin and activated partial thromboplastin times within postoperative 24 h were shorter than those before operation (P<0. 05), but there were no significant differences in values of surgical side body circumference and incidence rate of postoperative DVT be-fore and after the operation (P>0. 05). Conclusion Tranexamic Acid by intravenous drips during THA operation can effectively improve intraoperative and postoperative blood loss with less risks of incidence of postoperative thrombus and good prognosis for RA patients.关键词
氨甲环酸/关节炎,类风湿/关节成形术,置换,髋/失血,手术/深静脉血栓Key words
Tranexamic acid/Arthritis, rheumatoid/Arthroplasty, replacement, hip/Blood loss, surgical/Deep vein thrombosis分类
临床医学引用本文复制引用
吴焘,张国秋,张广源,曹志强..氨甲环酸不同给药方案对全髋关节置换类风湿关节炎患者预后的影响[J].解放军医药杂志,2016,28(7):86-91,6.基金项目
青海省科技厅项目(2014-2J-749) （2014-2J-749）
