Objective:To assess the effect of local application of tranexamic acid on the hidden blood-loss and inflammatory cytokines after unilateral total hip arthroplasty.Methods:From September 2014 to December 2015,82 osteoarthritis patients underwent total hip replacement (THA)in our hospital were enrolled and randomly divided into a control group and a treatment group.The patients were infused tranexamic acid articular cavity of the hip in treatment group,while those in control group were infused physiological saline articular cavity of the hip.The blood-loss,blood transfusion rate,prothrombin time (PT),partial thromboplastin time (APTT),the levels of C-reactive protein (CRP) and D-dimer as well as the incidence of complications were compared.Results:The postoperative total blood-loss,hidden blood-loss,volume of drainage and blood transfusion rate in the treatment group were lower than those in the control group (P ＜0.05).There were no significant differences in erythrocyte sedimentation rate (ESR),CRP,D-dimer,PT and APTT between the two group before and 48 h postoperation (all P ＞0.05).Postoperative lower extremity swelling was found in 7 cases and deep venous thrombosis (DVT) was further confirmed by color B ultrasonic inspection.These patients were recovered after antithrombotic therapy.Conclusion:The local perfusion of tranexamic acid in the hip joint cavity could significantly reduce blood-loss and did not increase systemic inflammation and risk of DVT in osteoarthritis patients.%目的:探讨髋关节腔局部灌注氨甲环酸对全髋关节置换术围手术期隐性失血量及炎症因子的影响.方法:将2014年9月至2015年12月广西医科大学第一附属医院收治的82例行全髋关节置换术的患者随机分为治疗组(42例)和对照组(40例),治疗组给予髋关节腔灌注氨甲环酸,对照组给予灌注等量生理盐水,观察两组患者术后失血量(总失血量、显性失血量和隐性失血量)、血沉(ESR)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、炎症因子[C-反应蛋白(CRP)和D-二聚体]及术后并发症发生情况.结果:治疗组术后总失血量、隐性失血量、术后引流量和输血率均明显低于对照组,差异具有统计学意义(均P ＜0.05);而两组术前及术后48 h ESR、CRP、D-二聚体、PT及APTT比较差异均无统计学意义(均P＞0.05).两组术后治疗组3例、对照组4例患者出现患肢肿胀,彩色B超检查发现患肢深静脉血栓形成,予以抗血栓治疗后恢复.结论:髋关节腔局部灌注氨甲环酸能有效减少全髋关节置换术围手术期总失血量、隐性失血量及降低输血率,不增加全身炎症程度及患肢静脉血栓形成的发生风险.
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