中国组织工程研究2017，Vol.21Issue(3)：329-334,6.DOI:10.3969/j.issn.2095-4344.2017.03.001
鸡尾酒疗法减少全膝关节置换后隐性失血
Cocktail therapy reduces hidden blood loss after total knee arthroplasty
摘要
Abstract
BACKGROUND:Blood loss after total knee arthroplasty is a common problem that wil affect the clinical effects. As a kind of hemostatic medicine, tranexamic acid has been more and more used in reducing bleeding after joint replacement. However, there are few studies concerning the combined use of tranexamic acid with other hemostatic drugs. OBJECTIVE:To evaluate the efficacy and safety of intra-articular administration of cocktail wine (tranexamic acid plus diluted-epinephrine) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty. METHODS:From July 2013 to October 2015, 113 patients scheduled to undergo total knee arthroplasty were randomized into two groups. Cocktail wine group (57 patients) received intra-articular cocktail wine (3 g tranexamic acid plus 0.25 mg diluted-epinephrine;1:200 000). Tranexamic acid group (56 patients) received 3 g topical tranexamic acid alone. Al patients were not drain inserted after the operation. During perioperative period, intraoperative blood loss, postoperative dominant blood loss, occult blood loss and al ogeneic blood transfusion were observed. Within postoperative 90 days, the incidences of symptomatic deep venous thrombosis and pulmonary embolism were observed. RESULTS AND CONCLUSION:(1) The topical administration of cocktail wine significantly reduced total blood loss (P=0.007), hidden blood loss (P=0.000) and transfusion rate (0%vs. 5.4%), without increasing the risk of thromboembolic and hemodynamic complications (P>0.05). (2) Therefore, the hemostatic effect of topical tranexamic acid plus diluted-epinephrine was better than tranexamic acid alone. Their combination does not produce severe adverse reactions, and can be used as an important method to reduce blood loss after total knee arthroplasty.关键词
骨科植入物/人工假体/局部应用/鸡尾酒/氨甲环酸/肾上腺素/异体输血/隐性失血/全膝关节置换/国家自然科学基金分类
医药卫生引用本文复制引用
时利军,高福强,孙伟,王卫国,程立明,郭万首..鸡尾酒疗法减少全膝关节置换后隐性失血[J].中国组织工程研究,2017,21(3):329-334,6.基金项目
国家自然科学基金面上项目(81372013)；中日友好医院院级课题(2014-4-QN-29)；中日友好医院青年科技英才计划(2014-QNYC-A-06) （81372013）
