四川医学2024，Vol.45Issue(3)：296-300,5.DOI:10.16252/j.cnki.issn1004-0501-2024.03.014
氨甲环酸关节腔灌洗联合静脉滴注对全膝关节置换术后失血量及炎性因子和凝血功能的影响
Changes of Blood Loss,Inflammatory Cytokines and Blood Coagulation Indexes of Articular Cavity Lavage Com-bined with Intravenous Tranexamic Acid in Total Knee Arthroplasty
杨文明 1沈科 1孔洁 1郭亮 1蔡文华 1王万垠1
作者信息
摘要
Abstract
Objective To investigate changes of blood loss,inflammatory cytokines and coagulation function indexes of articular cavity lavage combined with intravenous drip of different tranexamic acid in total knee arthroplasty.Methods From Feb-ruary 2018 to February 2019,patients with knee osteoarthritis who underwent unilateral TKA in our orthopedics department were selected as research objects,and they were randomly divided into control group,observation group 1 and observation group 2.The postoperative blood loss in 24 hours and 48 hours,preoperative and postoperative inflammatory factors(IFN-γ,IL-1β,IL-6),co-agulation function indicators fibrinogen,prothrombin time,activated partial thromboplastin time Thrombin time and C-reactive pro-tein(CRP)were compared.Results The postoperative drainage volume at 24 hours and 48 hours in observation group 1 and ob-servation group 2 were significantly lower than those in the control group.The hemoglobin levels in observation group 1 and obser-vation group 2 were higher than those in the control group 48 hours after surgery,and the drainage volume at 24 hours and 48 hours in observation group 2 was also significantly lower than that in observation group 1.The hemoglobin levels in observation group 2 at 48 hours after surgery were also higher than those in observation group 1,and the differences were statistically significant(P＜0.05).Compared with control group,postoperative IFN-γ in observation group 1 and observation group 2 were significantly high-er than those in control group-γ.And IL-1 β、IL-6 were significantly lower than those of control group after surgery.Compared with observation group 1 after surgery,observation group 2 patients had IL-1 after surgery β、The average level of IL-6 water de-creased significantly,and the differences were statistically significant difference(P＜0.05).Postoperative APTT and CRP in ob-servation group 2 were significantly lower than those in control group and observation group 1 with statistical significance(P＜0.05).The postoperative PT of control group was higher than that of observation group 1 and observation group 2 with statistically significant difference(P＜0.05).Conclusion Joint cavity lavage combined with intravenous drip of 10 mg/kg and 15 mg/kg tranexamic acid could both significantly reduce intraoperative and postoperative blood loss of TKA patients,control inflammatory factors,and improve coagulation function.In addition,joint cavity lavage combined with intravenous drip of 15 mg/kg tranexamic acid is better,which is worthy of clinical reference.关键词
全膝关节置换术/氨甲环酸/炎性细胞因子/凝血功能Key words
total knee replacement/tranexamic acid/inflammatory cytokines/coagulation function分类
医药卫生引用本文复制引用
杨文明,沈科,孔洁,郭亮,蔡文华,王万垠..氨甲环酸关节腔灌洗联合静脉滴注对全膝关节置换术后失血量及炎性因子和凝血功能的影响[J].四川医学,2024,45(3):296-300,5.
