中国医学创新2016，Vol.13Issue(22)：1-5,6,6.DOI:10.3969/j.issn.1674-4985.2016.22.001
静脉应用不同剂量氨甲环酸对全膝关节置换围手术期失血的影响
The Intravenous Application of Different Doses of Tranexamic Acid on Total Knee Replacement ;Effect of Perioperative Blood Loss
摘要
Abstract
Objective:To evaluate the intravenous injection of different dose of tranexamic acid on primary unilateral total knee arthroplasty peri operative blood loss quantity and safety influence.Method:From September 2012 to January 2014,250 cases of primary unilateral total knee arthroplasty in our hospital were selected as the research objects,they were randomly divided into the control group,tranexamic acid 10 mg/kg group,15 mg/kg group,20 mg/kg group and 30 mg/kg group,each group had 50 cases.Application of tranexamic acid of the four groups respectively at 30 min before tourniquet release the tranexamic acid in accordance with 10,15,20,30 mg/kg diluted in normal saline 100 mL by intravenous drip.Five groups began drainage in postoperative closed tube 2 h and drew tube postoperative 48 h.After 1,3,7 days hemoglobin content and hematocrit,most postoperative hemoglobin loss,total drainage volume and total blood loss,hidden blood loss, blood transfusion rate,postoperative venous thrombosis of the lower limbs occurred rate and other complications of five groups were recorded and compared.Result:The hemoglobin content and hematocrit of 1,3 and 7 d after operation among five groups were compared,there was no significant difference between the 20 mg/kg group and 30 mg/kg group(P>0.05),and there were significant differences between the other groups(P<0.01). Most postoperative hemoglobin loss,total drainage volume,total blood loss and hidden blood loss in five groups were compared,there was no significant difference between the 20 mg/kg group and 30 mg/kg group,and there were significant differences between the other groups(P<0.01).The blood transfusion rate between four groups of application tranexamic acid compared with control group had statistically significant(P<0.01),among 15,20 and 30 mg/kg three groups were not statistically significant differences(P>0.05).Venous thromboembolism(VTE), infection,renal failure and other complications were not found in the five groups.Conclusion:Intravenous application of 10,15,20 and 30 mg/kg dose of tranexamic acid can effectively reduce the blood loss and blood transfusion rates of the patients undergoing total knee arthroplasty,and will not increase the risk of perioperative venous thrombosis.To reduce bleeding,blood transfusion rate and possible risk analysis,20 mg/kg dose was the best dose.关键词
人工全膝关节置换术/氨甲环酸/静脉滴注Key words
Total knee arthroplasty/Tranexamic acid/Intravenous infusion引用本文复制引用
潘云春,刘琳娜,张其亮..静脉应用不同剂量氨甲环酸对全膝关节置换围手术期失血的影响[J].中国医学创新,2016,13(22):1-5,6,6.基金项目
青岛市优秀青年医学人才项目基金支持 （）
