局部应用氨甲环酸的全髋关节置换:回顾性分析不同时间引流量差异

摘要

BACKGROUND:Topical tranexamic acid (TXA) administration has been described to be effective in decreasing blood loss in total hip arthroplasty (THA).Most of research focus on the postoperative total drainage,but the drainage at different time points after replacement is little reported.OBJECTIVE:To investigate the effect of topical TXA on the volume of drainage at different time points after THA.METHODS:Data of 79 cases of primary unilateral THA were analyzed retrospectively,and allotted to two groups.TXA group (n=38) was subjected to the reverse perfusion of 1.5 g of TXA (50 mL) by drainage tube after THA,and control group (n=41) was given 50 mL of normal saline in the same way.The postoperative drainage at 1,2 and 3 days,total postoperative drainage,and hemoglobin level at postoperative 3 days were collected and compared between two groups.RESULTS AND CONCLUSION:There was no significant difference in the baseline data between two groups (P ＞ 0.05).(1) The postoperative drainage at 1 day and total drainage in the TXA group was significantly lower than that in the control group,and the drainage showed no significant difference at postoperative 2 and 3 days between two groups (P ＞0.05).(2) The hemoglobin level was significantly increased in the TXA group compared with the control group at 3 days postoperatively (P ＜ 0.05).(3) To conclude,the topical TXA administration can reduce the postoperative drainage in primary unilateral THA,especially at the first day.%背景:氨甲环酸局部应用于全髋关节置换可显著减少围手术期失血量,然而一直以来的研究重点在于关节置换后总引流量方面,对于置换后不同时间段内的引流量观察甚少.目的:观察局部应用氨甲环酸对全髋关节置换后不同时间的引流量的影响.方法:回顾性分析初次行单侧全髋关节置换的病例资料共79例,分为2组.试验组38例关节置换后经引流管逆行灌注氨甲环酸1.5 g(50 mL),对照组41例以同样方法灌注50 mL生理盐水.统计2组关节置换后第1,2,3天引流量、总引流量、置换后第3天血红蛋白.结果与结论:2组基线资料差异无统计学意义.①试验组置换后第1天引流量显著小于对照组(P＜0 05),第2,3天2组引流量差异无显著性意义(P＞0 05);试验组总引流量显著小于对照组(P＜0.05);②试验组置换后第3天血红蛋白显著高于对照组(P＜0 05);③结果表明,局部应用氨甲环酸可减少初次单侧全髋关节置换后引流量,尤以置换后第1天明显.