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膝关节腔注射氨甲环酸对单纯半月板损伤患者关节肿胀、疼痛、关节功能恢复的影响
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| 篇名： | 膝关节腔注射氨甲环酸对单纯半月板损伤患者关节肿胀、疼痛、关节功能恢复的影响 |
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| 摘要： | 目的：探讨膝关节腔注射氨甲环酸对单纯半月板损伤患者关节肿胀程度、疼痛以及关节功能恢复的影响。方法：选择2016年10月－2017年4月重庆市人民医院骨科收治的62例拟行膝关节镜手术的单纯半月板损伤患者，按随机数字表法分为对照组和观察组，各31例。两组患者均于膝关节镜下行半月板切除或修整术。对照组患者术中伤口缝合后给予0.9％氯化钠注射液10 mL，膝关节腔注射；观察组患者术中伤口缝合后给予注射用氨甲环酸2.0 g，加入0.9％氯化钠注射液10 mL中，膝关节腔注射。所有患者均未安置引流管，加压包扎伤口后松止血带。观察两组患者术前及术后1、3、5、7 d膝关节周径、视觉模拟评分法（VAS）评分，术前及术后1个月Lysholm评分，并记录不良反应发生情况。结果：术前，两组患者膝关节周径、VAS评分、Lysholm评分比较，差异均无统计学意义（P＞0.05）。术后，两组患者1、3、5、7 d膝关节周径均显著大于同组术前，但观察组术后1、3 d显著小于同期对照组，差异均有统计学意义（P＜0.05）；术后5、7 d，两组患者膝关节周径比较，差异均无统计学意义（P＞0.05）。术后，观察组患者1、3 d及对照组患者1、3、5 d的VAS评分均显著高于同组术前，但观察组术后1、3、5 d显著低于同期对照组，差异均有统计学意义（P＜0.05）；观察组术后5、7 d及对照组术后7 d与同组术前比较，两组间术后7 d比较，差异均无统计学意义（P＞0.05）。术后1个月，两组患者Lysholm评分均显著高于同组术前，且观察组显著高于对照组，差异均有统计学意义（P＜0.05）。两组患者用药期间均未见严重不良反应发生，术后均无深静脉血栓发生。结论：膝关节镜术后关节腔注射氨甲环酸可有效减轻单纯半月板损伤患者的早期关节肿胀程度，缓解术后早期疼痛，促进术后关节功能恢复，且安全性较高。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of intra-articular injection of tranexamic acid on joint swelling， pain and recovery of joint function in patients with simple meniscus injury. METHODS： A total of 62 patients with simple meniscus injury receiving arthroscopic surgery of the knee in orthopedics department of Chongqing people’s hospital during Oct. 2016-Apr. 2017 were selected and divided into control group and observation group according to random table， with 31 cases in each group. Both groups received meniscus excision or trimming under knee arthroscopy. Control group was given intra-articular injection of 0.9％ Sodium chloride injection 10 mL after wound suture. Observation group was given intra-articular injection of Tranexamic acid for injection 2.0 g added into 0.9％ Sodium chloride injection 10 mL after wound suture. The drainage tube was not placed in all the patients， The tourniquet was loosened after the pressurized dressing of wound. Circumferential diameter of the knee and VAS scores of 2 groups were observed before surgery， 1， 3， 5 and 7 d after surgery. Lysholm scores were observed before and one month after surgery. The occurrence of ADR was recorded. RESULTS： There was no statistical significance in circumferential diameter of the knee， VAS score or Lysholm score between 2 groups before surgery （P＞0.05）. 1， 3， 5 and 7 d after surgery， circumferential diameter of the knee in 2 groups was significantly bigger than before surgery， but the observation group was significantly smaller than the control group 1， 3 d after surgery， with statistical significance （P＜0.05）. There was no statistical significance in circumferential diameter of the knee between 2 groups 5 and 7 d after surgery （P＞0.05）. VAS score of observation group 1， 3 d after surgery and control group 1， 3 and 5 d after surgery were significantly higher than before surgery， but the observation group was significantly lower than the control group 1， 3， 5 d after surgery， with statistical significance （P＜0.05）. There was no statistical significance in observation group 5， 7 d after surgery and control group 7 d after surgery， compared to before surgery and 7 d after surgery （P＞0.05）. One month after surgery， Lysholm scores of 2 groups were significantly higher than before surgery， and the observation group was significantly higher than the control group， with statistical significance （P＜0.05）. No severe ADR was found in 2 groups during medication， and there also was not deep venous thrombosis after surgery. CONCLUSIONS： Intra-articular injection of tranexamic acid can effectively reduce the degree of early knee swelling after knee arthroplasty， relieve postoperative early pain. It promotes the recovery of knee function with good safety. |
| 期刊： | 2018年第29卷第8期 |
| 作者： | 李明晋，陈小华，唐晓莉，李凑，梁婷，王海若，曾凤玲，王霁，刘曦 |
| AUTHORS： | LI Mingjin，CHEN Xiaohua，TANG Xiaoli，LI Cou，LIANG Ting，WANG Hairuo，ZENG Fengling，WANG Ji，LIU Xi |
| 关键字： | 氨甲环酸；膝关节腔注射；单纯半月板损伤；膝关节镜术；肿胀；疼痛；关节功能 |
| KEYWORDS： | Tranexamic acid； Intra-articular injection； Simple meniscus injury； Knee arthroscopy； Swelling； Pain； Joint function |
| 阅读数： | 364 次 |
| 本月下载数： | 10 次 |
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