氨甲环酸不同用药方案对同期双侧全膝关节置换术围术期患者出血及术后并发症的影响
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篇名: 氨甲环酸不同用药方案对同期双侧全膝关节置换术围术期患者出血及术后并发症的影响
TITLE:
摘要: 目的:观察氨甲环酸不同用药方案对同期双侧全膝关节置换术(TKA)围术期患者出血及术后并发症的影响。方法:选择我院以行同期双侧TKA的患者70例,随机分为对照组(n=35)和观察组(n=35)。对照组患者术前30 min给予氨甲环酸注射液15 mg/kg,静脉滴注,观察组患者术前30 min、缝合切口前30 min分别给予氨甲环酸注射液15 mg/kg,静脉滴注。观察并比较两组患者手术时间、总失血量、术中失血量、术后引流量、治疗前和术后3 d纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平、术后并发症发生情况和不良反应发生情况。结果:两组患者手术时间、术中失血量和不良反应发生率比较,差异无统计学意义(P>0.05);观察组患者总失血量、术后引流量显著少于对照组,术后并发症发生率显著低于对照组,差异均有统计学意义(P<0.05);两组患者治疗前和术后3 d,FIB水平和PT、APTT比较,差异均无统计学意义(P>0.05)。结论:同期双侧TKA患者术前30 min、手术结束前30 min静脉滴注氨甲环酸注射液能降低围术期出血,减少术后并发症的发生,安全性较好。
ABSTRACT: OBJECTIVE: To observe the effects of different regimens of tranexamic acid on perioperative bleeding and postoperative compliance of simultaneous bilateral total knee arthroplasty(TKA). METHODS: A total of 70 patients undergoing simultaneous bilateral TKA in our hospital were randomly divided into control group and observation group, with 35 cases in each group. Control group was given Tranexamic acid injection 15 mg/kg 30 min before surgery. Observation group was given Tranexamic acid injection 15 mg/kg, 30 min before surgery and 30 min before suturing incision. The operation duration,total blood loss,intraoperative blood loss, postoperative drainage as well as the levels of FIB, PT, APTT before trectment and 3 d after surgery,the occurrence of postoperative compliance and ADR were observed and compared between 2 groups. RESULTS: There was no statistical significance in operation duration, intraoperative blood loss and rate of ADR between 2 groups (P>0.05). The total blood loss, postoperative drainage and the incidence of complications of observation group were significantly lower than those of control group, with statistical significance (P<0.05). There was no statistical significance in coagulation indexes (FIB, PT and APTT) between 2 groups before treatment and 3 d after surgery, with statistical significance (P>0.05). CONCLUSIONS: The application of tranexamic acid 30 min before simultaneous bilateral TKA and 30 min before the end of surgery can reduce perioperative bleeding and postoperative venous thromboembolism with good safety.
期刊: 2017年第28卷第18期
作者: 赵学寨,孟彩云,刘明辉,李海军
AUTHORS: ZHAO Xuezhai,MENG Caiyun,LIU Minghui,LI Haijun
关键字: 氨甲环酸;用药方案;同期双侧全膝关节置换术;围术期;出血
KEYWORDS: Tranexamic acid; Different regimens; Simultaneous bilateral total knee arthroplasty; Perioperative; Bleeding
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