生物骨科材料与临床研究2026，Vol.23Issue(4)：35-40,6.DOI:10.3969/j.issn.1672-5972.2026.04.007
血栓弹力图评价老年股骨颈骨折患者围手术期应用大剂量氨甲环酸安全性及有效性的定量研究
A quantitative study on the safety and efficacy of perioperative high-dose tranexamic acid in elderly patients with femoral neck fractures evaluated by TEG
摘要
Abstract
Objective To explore the safety and efficacy of thromboelastography(TEG)in quantitatively evaluating the perioperative application of high-dose tranexamic acid in elderly patients with femoral neck fractures.Methods Patients with femoral neck fractures who underwent artificial femoral head replacement in the department of orthopedics,the Second Affiliated Hospital of Chengdu Medical College(China National Nuclear Corporation 416 Hospital)from December 2021 to September 2024 were selected as the research subjects.They were randomly divided into 7 groups,with 30 cases in each group.The experimental groups were groups A,B,C,D,E,and F,while the remaining group was the control group,which did not receive tranexamic acid injection.In group A,the initial dose of 20 mg/kg was intravenously administered before surgery,and a supplementary dose of 10 mg/kg was given every 3 hours for a total of two times.In group B,the initial dose of 20 mg/kg was intravenously administered before surgery,and a supplementary dose of 20 mg/kg was given every 3 hours for a total of two times.In group C,the initial dose of 20 mg/kg was intravenously administered before surgery,and then a supplementary dose of 10 mg/kg was given 5 times within 24 hours.The first two supplementary doses were given at 3-hour intervals,and the last three were given at 6-hour intervals.In group D,the initial dose of 40 mg/kg was intravenously administered before surgery,with no supplementary dose thereafter.In group E,the initial dose of 40 mg/kg was intravenously administered before surgery,and a supplementary dose of 10 mg/kg was given every 3 hours for a total of two times.In group F,the initial dose of 60 mg/kg was intravenously administered before surgery,and a supplementary dose of 10 mg/kg was given every 3 hours for a total of two times.One group served as the control group,in which no tranexamic acid was injected.The TEG parameters,blood loss volume,transfusion rate,and thrombosis incidence of each group were compared on the third day after surgery.Results In terms of total blood loss,the experimental group showed a significantly lower amount compared to the control group(P<0.05).However,there was no statistically significant difference in the blood transfusion rate and the incidence of DVT among the 7 groups of patients(P>0.05).All parameters of TEG in the control group were within the normal range;compared with the control group,the R values of groups A,B,C,D,and E in the experimental group were significantly lower on the third day after surgery(P<0.05),while there was no significant difference in group F(P>0.05).Compared with the control group,the α angle and MA in the experimental group increased significantly,with statistically significant differences(P<0.05).There was no significant difference in the K value between the experimental groups and the control group(P>0.05).The CI values of groups B,C,E,and F were significantly higher than those of the control group(P<0.05),while there was no significant difference in groups A and D(P>0.05).Conclusion Sequential treatment with high-dose tranexamic acid can effectively reduce blood loss volume,and there is no significant difference in the perioperative coagulation function status among different dose groups.关键词
血栓弹力图(TEG)/氨甲环酸/股骨颈骨折Key words
Tthromboelastography(TEG)/Tranexamic acid/Femoral neck fracture分类
医药卫生引用本文复制引用
赫明亮,严钰皓,包利帅,刘选泽,肖国庆..血栓弹力图评价老年股骨颈骨折患者围手术期应用大剂量氨甲环酸安全性及有效性的定量研究[J].生物骨科材料与临床研究,2026,23(4):35-40,6.基金项目
四川省医学会(恒瑞)专项课题(2021HR66) （恒瑞）
