实用医学杂志 ›› 2022, Vol. 38 ›› Issue (14): 1788-1792.doi: 10.3969/j.issn.1006⁃5725.2022.14.014

• 临床研究 • 上一篇    下一篇

氨甲环酸关节腔周围注射与关节腔灌注在全膝关节置换术中的疗效比较

张军 满家政 冯仕明 马超 王涛    

  1. 东南大学附属徐州市中心医院骨科(江苏徐州 221009)

  • 出版日期:2022-07-25 发布日期:2022-07-25
  • 通讯作者: 王涛 E⁃mail:jsxzwt@163.com
  • 基金资助:
    江苏省高层次卫生人才“六个一工程”(编号:LGY2020028)

Hemostatic effect of tranexamic acid by peri ⁃articular injection versus intra ⁃articular perfusion during total knee arthroplasty:A randomized controlled trial.

 ZHANG Jun,MAN Jiazheng,FENG Shiming,MA Chao,WANG Tao   

  1. Department of Orthopaedics,Xuzhou Central Hospital,Southeast University,Xuzhou 221009 China

  • Online:2022-07-25 Published:2022-07-25
  • Contact: WANG Tao E⁃mail:jsxzwt@163.com

摘要:

目的 比较全膝关节置换术中氨甲环酸关节腔周围注射与关节腔灌注在减少术后出血的 临床疗效。方法 选取 2018 6 月至 2020 2 月我院收治 140 例膝关节骨性关节炎行全膝关节置换术患者,依纳入与排除标准筛选出 132 例随机分为观察组 66 例(关节腔周围注射)和对照组 66 例(关节腔灌 注),比较两组患者术后总失血量、24 h引流量、术后第3天隐性失血量,以及术后第5天、第10天NRS 疼痛 评分、大腿、髌上及小腿周径。结果 观察组和对照组总失血量和术后第 3 天隐性失血量差异无统计学意 义(P > 0.05);而术后 24 h 引流量观察组明显多于对照组,差异有统计学意义(P < 0.05)。术后第 5 天及第 10 天两组 NRS 疼痛评分、下肢肿胀差异无统计学意义(P > 0.05);两组术后血栓并发症差异无统计学意义 P > 0.05)。结论 全膝关节置换术中关节腔周围注射氨甲环酸在减少术后出血方面并没有优于关节腔 灌注,但考虑引流管存在的风险,关节腔周围注射氨甲环酸仍是不错的选择。

关键词:

氨甲环酸, 全膝关节置换术, 关节腔周围注射, 关节腔灌注

Abstract:

Objective To compare the clinical efficacy of tranexamic acid by peri⁃articular injection vs. intra ⁃ articular perfusion for reducing postoperative bleeding during total knee arthroplasty. Methods A total of 140 patients with knee osteoarthritis who were admitted into our hospital from June 2018 to February 2020 for total knee arthroplasty were selected and randomly divided into observation group and control group in equal number treated with peri⁃articular injection and intra⁃articular perfusion with tranexamic acid,respectively. The two groups were compared in terms of total postoperative blood loss,24⁃hour drainage volume and hidden blood loss at day 3 postoperatively,as well as NRS scores,circumference of thigh,superior patella and calf at days 5 and 10 post⁃ operatively. Results There were no significant differences in total blood loss and hidden blood loss at day 3 after operation between the groups. The 24⁃hour drainage volume of the observation group was significantly higher than that of the control group. There were no significant differences in the NRS score and lower limb swelling between the two groups at days 5 and 10 after operation. There was no significant difference in postoperative thrombotic complications between the two groups. Conclusion During total knee arthroplasty,peri ⁃ articular injection with tranexamic acid is as effective in reducing postoperative bleeding as intra⁃articular perfusion with the acid. However it is still a good choice in consideration of the drainage tube⁃involved risks.

Key words:

tranexamic acid, total knee arthroplasty, peri?articular injection, intra?articular perfusion

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