【摘要】 背景:越来越多的患者行膝关节单髁置换治疗,既往氨甲环酸在单髁置换过程中为关节腔内注射,关于单髁置换围术期氨甲环酸静脉滴注联合局部应用的研究并未见报道。目的:探讨静脉联合局部应用氨甲环酸在膝关节单髁置换过程中的止血效果及安全性。方法:回顾性分析2015年6月至2019年12月中山市人民医院骨一科收治的行初次单侧单髁置换的48例膝关节骨关节炎患者的病历资料。根据围术期是否使用氨甲环酸分为2组,试验组30例手术切皮前静脉点滴1.0 g氨甲环酸及术中关闭切口前0.5 g氨甲环酸与鸡尾酒混合局部注射,对照组18例术前未使用氨甲环酸及术中关闭切口前不配有氨甲环酸等量鸡尾酒注射。对比分析2组患者显性、隐性及总失血量、术后第2天血红蛋白及红细胞压积丢失量、输血例数、术后及总住院时间、术后30 d内任何并发症发生情况。结果与结论:①试验组的显性、隐性及总失血量、术后第2天血红蛋白及红细胞压积丢失量均显著少于对照组,差异有显著性意义(P <0.05);②2组在输血例数、术后及总住院时间与术后30 d内并发症方面差异均无显著性意义(P> 0.05);③结果证实,静脉联合局部应用氨甲环酸在膝关节单髁置换术中有明显的止血效果及安全性。更多还原

【Abstract】 BACKGROUND: More and more patients are undergoing unicompartmental knee arthroplasty. Tranexamic acid has been injected into the articular cavity in unicompartmental knee arthroplasty in the past, and effects of intravenous combined with topical administration of tranexamic acid in unicompartmental knee arthroplasty have not been studied. OBJECTIVE: To investigate the hemostatic effect and safety of intravenous combined with topical administration of tranexamic acid in unicompartmental knee arthroplasty. METHODS: A retrospective analysis was conducted on the medical records of 48 patients with knee osteoarthritis who underwent primary unilateral unicompartmental knee arthroplasty in the First Department of Orthopedics of Zhongshan People’s Hospital from June 2015 to December 2019. The patients were divided into two groups according to perioperative use of tranexamic acid. The 30 patients in the experimental group received intravenous infusion of 1.0 g tranexamic acid before surgery and 0.5 g tranexamic acid mixed with cocktail before closing the incision. The 18 patients in the control group did not receive tranexamic acid before surgery or cocktail with tranexamic acid before closing the incision. The dominant, hidden and total blood loss of the two groups, the loss of hemoglobin and hematocrit on day 2 after the operation, the number of blood transfusion cases, the duration of postoperative and total hospital stay, and any complications within 30 days after the operation were compared and analyzed. RESULTS AND CONCLUSION:(1) The dominant, hidden and total blood loss, and the loss of hemoglobin and hematocrit were significantly less in the experimental group than in the control group on day 2 after surgery, with statistically significant differences(P < 0.05).(2) There was no statistically significant difference between the two groups in the number of blood transfusions, postoperative and total hospital stay and any complications within 30 days after surgery(P > 0.05).(3) The results confirmed that the intravenous combined with topical administration of tranexamic acid in the unicompartmental knee arthroplasty has obvious hemostatic effect, and has a certain safety.更多还原