【摘要】 目的探讨不同剂量氨甲环酸(TA)对初次全髋关节置换术(THA)围手术期失血量的影响。方法 160例行初次单侧THA的股骨颈骨折患者分为4组:TA 10 mg/kg组、TA 15 mg/kg组、TA 20 mg/kg组、对照组,每组各40例。手术开始前15 min,TA组将TA分别按10、15、20 mg/kg的剂量稀释于250 ml生理盐水后静滴;对照组予生理盐水250 ml静滴。比较各组围手术期总失血量、显性失血量、隐性失血量、异体输血量和静脉血栓发生率。结果 TA 10 mg/kg组、15 mg/kg组、20 mg/kg组围手术期总失血量、显性失血量、隐性失血量、异体输血量与对照组相比差异均有统计学意义(P<0.05);TA 15 mg/kg组、TA 20 mg/kg组与TA 10 mg/kg组相比,总失血量、隐性失血量和异体输血量差异均有统计学意义(P<0.05)。各组深静脉血栓(DVT)发生率比较差异均无统计学意义(P>0.05)。结论初次THA术前静脉使用TA能明显降低患者围手术期失血量和异体输血量,剂量15 mg/kg、20 mg/kg更为有效。更多还原

【Abstract】 Objective To investigate the efficacy of different doses of tranexamic acid( TA) use for perioperative blood loss control primary unilateral total hip arthroplasty( THA). Methods 160 patients underwent primary THA due to femoral neck fracture were randomly divided into TA 10 mg / kg group,TA 15 mg / kg group,TA 20 mg / kg group and the control group with 40 cases in each group. In the TA group,10 mg / kg,15 mg / kg or 20 mg / kg TA with250 ml normal saline was infused intravenously within 15 minutes before skin incision,while an equal volume of normal saline was given instead in the control group. Total blood loss,visible blood loss,hidden blood loss,blood transfusion volume,blood transfusion rate,and the rate of deep vein thrombosis of different groups were compared. Results In TA 10 mg / kg group,TA 15 mg / kg group or TA 20 mg / kg group,the total blood loss,visible blood loss,hidden blood loss and blood transfusion volume were all less than those in the control group. The difference had statistical significance( P < 0. 05). Compared with TA 10 mg / kg group,the total blood loss,hidden blood loss and blood transfusion volume were significantly reduced in TA 15 mg / kg group or TA 20 mg / kg group( P < 0. 05). While the incidence of deep venous thrombosis had no statistically significant differences among each group( P > 0. 05). Conclusions Intravenous infusion of TA within 15 minutes before skin incision reduces the perioperative blood loss and blood transfusion volume in primary unilateral THA significantly. Compared with 10 mg / kg,15 mg / kg or 20 mg / kg TA gains more advantage of less perioperative blood loss.更多还原