[10-氨甲环酸使用时机在全髋关节置换围手术期失血量的临床研究二院刘丙根.docVIP

氨甲环酸使用时机在全髋关节置换围手术期失血量的临床研究 刘丙根 庞清江 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)对围手术期影响。方法：选取2012年3月至2013年1月行初次单侧THA患者59例，其中男24例，女35例；年龄57-85岁，平均71岁，采用随机数字表法分为：A组(20例，不使用氨甲环酸)、B组(20例，术前15min使用氨甲环酸15mg/kg静滴)和C组(19例，术前15min使用氨甲环酸15mg/kg及术后6h使用氨甲环酸1g静滴)。计算总失血量、显性失血量及隐性失血量。结果：A、B、C组显性失血量分别为(508.7±135.8)ml、(417.7±87.4)ml、(341.4±75.1)ml，其中A组与B组差异有统计学意义(P0.05)，A组与C组差异有统计学意义(P0.05),B组与C组差异有统计学意义(P0.05)。A、B、C组隐性失血量分别为(308.4±61.0)ml、(194.2±37.0)ml、(192.7±39.0)ml，其中A组与B组差异有统计学意义(P0.05)，A组与C组差异有统计学意义(P0.05),B组与C组差异无统计学意义(P0.05)。 A、B、C组总失血量分别为(817.1±151.5)ml、(611.9±79.6)ml、(534.1±65.0)ml，其中A组与B组差异有统计学意义(P0.05)，A组与C组差异有统计学意义(P0.05),B组与C组差异有统计学意义(P0.05)。结论:术前使用氨甲环酸（15mg/kg）能明显减少初次单侧THA围手术期的失血量，减少患者的输血率。术前15min使用氨甲环酸较术后及不使用方面在减少隐性失血量方面更有优势，而联合使用氨甲环酸可以减少显性及总失血量，对隐性失血没有优势。 关键词：氨甲环酸 关节成形术 髋关节 围手术期失血量 临床研究 Relationship of Tranexamic Acid for Reduction of Blood Loss during Total Hip Arthroplasty [Abstract] Objective：To assess the effect of tranexamic acid on perioperative blood loss after the preliminary unilateral total hip arthtoplasty(THA)．Methods： The study involved 59 patients who received primary unilateral THA from March 2010 to January 2011。They were 24 males and35 females，at 57 to 85 years of age(average 71 years)．59 patients were randomized to dividing into Group A(n=20)，The group received normal saline instead of tranexamic acid in the same manner. Group B(n=20)，15 minutes prior to incision, got a single injection of tranexamic acid (15 mg/kg) before surgical incision，Group C(n=20)，got a single injection of tranexamic acid (15 mg/kg) before surgical incision and 1 g of tranexamic acid administered again at 6 hours after surgical．Total blood loss，visible blood loss，and hidden blood loss in each group were calculated．Results： Visible blood loss in Groups A，B， and C was 508.7±135.8)ml、(417.7±87.4)ml、(341.4±75.1)ml respectively．Moreover，difference of Visible blood loss was significant between Groups A and B(P0.05)，difference of Visible blood loss was s