氨甲环酸使用时间与全髋关节置换术隐性失血的临床研究

doi:10.3760/cma.j.issn.1001-8050.2013.06.017

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摘要目的探讨氨甲环酸对初次单侧全髋关节置换术（total hip arthroplasty, THA）显性及隐性失血的影响。方法选取2010年3月-2011年9月行初次单侧THA患者60例，其中男18例，女42例；年龄58～86岁，平均74.5岁，诊断均为股骨颈骨折。按分层随机分组法分为：A组（20例，不使用氨甲环酸）、B组（20例，术中使用氨甲环酸）和C组（20例，术前1 h使用氨甲环酸）。计算总红细胞丢失量、显性红细胞丢失量及隐性红细胞丢失量。结果 A、B、C组显性红细胞丢失量分别为（95.4±17.7) ml、(45.5±11.5) ml、(45.3±8.4) ml，其中A组与B组差异有统计学意义（P＜0.05），B组与C组差异无统计学意义（P＞0.05）。 A、B、C组隐性红细胞丢失量分别为(322.4±57.7) ml、(203.8±46.6) ml、(137.6±34.7) ml，其中A组与B组差异有统计学意义（P＜0.05），B组与C组差异有统计学意义（P＜0.05）。结论氨甲环酸能明显减少初次单侧THA的显性及隐性失血量；术前1 h使用氨甲环酸较术中使用在减少隐性失血量方面更有优势。

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	傅峥
	张健

关键词 ：氨甲环酸, 关节成形术, 置换, 髋, 股骨颈骨折, 失血, 手术

Abstract：Objective To assess the impact of tranexamic acid on visible and hidden blood loss after the preliminary unilateral total hip arthtoplasty (THA). Methods The study involved 60 patients who received primary unilateral THA due to femoral neck fracture from March 2010 to September 2011. They were 18 males and 42 females, at 58 to 86 years of age (average 74.5 years). They were divided into Group A (n=20), not given tranexamic acid, Group B (n=20), given tranexamic acid in operation, Group C (n=20), given tranexamic acid at preoperative one hour according to stratified random method. Total red blood cell loss, visible red blood cell loss, and hidden red blood cell loss in each group were calculated. Results Visible red blood cell loss in Groups A, B, and C was (95.4±17.7) ml, (45.5±11.5) ml, and (45.3±8.4) ml respectively. Moreover, difference of visible red blood cell loss was significant between Groups A and B (P＜0.05), but insignificant between Groups B and C (P＞0.05). Hidden red blood cell loss in Groups A, B, and C was (322.4±57.7) ml, (203.8±46.6) ml, and (137.6±34.7) ml respectively, with significant difference between Groups A and B (P＜0.05) and between Groups B and C (P＜0.05). Conclusions Tranexamic acid reduces the visible and hidden blood loss in primary unilateral THA significantly. While tranexamic acid administered at preoperative one hour gains advantage of less hidden blood loss over the intraoperative administration.

Key words： Tranexamic acid Arthroplasty, replacement, hip Femoral neck fractures Blood loss, surgical

通讯作者: 张健，电话：023-89011012，Email：68733235@sohu.com

引用本文:

傅峥,张健. 氨甲环酸使用时间与全髋关节置换术隐性失血的临床研究[J]. 中华创伤杂志, 2013, 29(6): 541-544.

FU Zheng,ZHANG Jian. Relationship of tranexamic acid therapy duration with hidden blood loss after total hip arthroplasty[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(6): 541-544.

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http://www.zhcszz.com/CN/10.3760/cma.j.issn.1001-8050.2013.06.017 或 http://www.zhcszz.com/CN/Y2013/V29/I6/541

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