目的 比较全膝关节置换术(TKA)术中静脉滴注与关节腔内注射氨甲环酸对术后失血的影响.方法将100名TKA患者按照随机数字表法分为两组,每组50例.实验组给予关节腔内注射氨甲环酸,对照组给予静脉滴注氨甲环酸.比较两组总失血量、术中失血量、显性失血量、术后第3天RBC、HGB、HCT水平变化及输血量和并发症发生的情况.结果 两组手术时间、止血带使用时间、术中失血量、术后引流量、总失血量及术后第3天RBC、HGB、HCT水平比较差异均无统计学意义(P>0.05);两组输血量和并发症发生情况比较差异无统计学意义(P>0.05).结论 关节腔内注射氨甲环酸可有效地减少TKA总失血量及RBC、HGB、HCT水平等指标变化,并不增加输血量及并发症发生,且使用方便,理论上安全性更高.%Objective To compare the effect of tranexamic acid through intra-articular and intravenous on postopera-tive blood lost in primary total knee arthroplasty. Methods The 100 patients who received primary total knee arthro-plasty were divided into two different groups according to random number table;50 cases in each group;and received intra-articular injection or intravenous drip tranexamic acid. General postoperative blood loss, intraoperative blood loss,obvious blood loss,postoperative 3 d of RBC,HGB,HCT levels change,blood transfusion volume and compli-cation were compared between two groups. Results There were no statistically significant differences on operation time,tourniquet time,intraoperative blood loss,postoperative drainage,general postoperative blood loss and postoper-ative 3 d of RBC,HGB,HCT levels(P>0.05). There were no statistically significant differences in blood transfu-sion volume and complications(P>0.05). Conclusions Applying intra-articular injection tranexamic acid is as ef-fective as intravenous drip tranexamic acid,which doesn′t increase blood transfusion volume and complication in pri-mary total knee arthroplasty. Intra-articular injection tranexamic acid is much more safe and convenient theoretically.
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