摘要
目的探讨不同给药途径应用氨甲环酸对股骨颈骨折全髋关节置换术患者的止血效果。方法90例股骨颈骨折全髋关节置换术患者,采用随机数字表法分为A、B、C三组,每组30例。三组患者给予氨甲环酸进行止血治疗。A组采用单次静脉注射给药,B组采用关节腔内注射给药,C组采用多次静脉注射给药。对比三组围手术期指标(术中失血量、总出血量以及术后引流量),术后1、3 d的血红蛋白(Hb)与平均红细胞体积(MCV)水平,术后并发症[切口感染、肺部感染、皮下积血、下肢深静脉血栓形成(DVT)以及尿路感染]发生率。结果C组患者的总出血量(685.19±42.62)ml少于A组的(831.53±231.29)ml、B组的(883.62±306.53)ml,A组患者的总出血量少于B组,差异具有统计学意义(P<0.05);C组患者的术后引流量(153.92±41.08)ml少于A组的(282.65±67.18)ml、B组的(177.16±43.62)ml,B组患者的术后引流量少于A组,差异具有统计学意义(P<0.05)。术后1 d,C组患者的Hb(99.59±13.53)g/L、MCV(30.56±3.26)fl均高于A组的(90.26±10.18)g/L、(26.62±3.06)fl和B组的(92.06±10.63)g/L、(27.19±3.05)fl,差异具有统计学意义(P<0.05)。术后3 d,C组患者的Hb(95.26±9.19)g/L、MCV(28.79±3.01)fl均高于A组的(85.17±9.05)g/L、(26.01±2.36)fl和B组的(86.16±9.13)g/L、(26.13±2.51)fl,差异具有统计学意义(P<0.05)。C组患者的术后并发症发生率3.33%低于A组的23.33%、B组的20.00%,差异具有统计学意义(P<0.05)。结论股骨颈骨折全髋关节置换术患者采用氨甲环酸多次静脉注射给药更有利于提升止血效果,降低并发症发生率。
Objective To discuss the hemostatic effect of tranexamic acid applied by different routes of administration in femoral neck fractures patients undergoing total hip arthroplasty.Methods A total of 90 cases of femoral neck fractures patients undergoing total hip arthroplasty were divided into group A,group B and group C according to random numerical table,with 30 cases in each group.All three groups received tranexamic acid for hemostatic treatment.Group A was administered by a single intravenous injection,group B was administered by intra-articular injection,and group C was administered by multiple intravenous injections.The perioperate indicators(intraoperative blood loss,total blood loss,and postoperative drainage),hemoglobin(Hb)and mean corpuscular volume(MCV)at 1 and 3 d after surgery,and postoperative complications[incision infection,lung infection,subcutaneous hemorrhage,deep vein thrombosis(DVT)and urinary tract infection]of the three groups were compared.Results The total blood loss(685.19±42.62)ml of group C was less than(831.53±231.29)ml of group A and(883.62±306.53)ml of group B;the total blood loss of group A was less than that of group B.All the difference was statistically significant(P<0.05).The postoperative drainage(153.92±41.08)ml in group C was less than(282.65±67.18)ml in group A and(177.16±43.62)ml in group B,and the postoperative drainage in group B was less than that in group A.All the difference was statistically significant(P<0.05).At 1 d after surgery,Hb(99.59±13.53)g/L and MCV(30.56±3.26)fl in group C were higher than that in group A[(90.26±10.18)g/L,(26.62±3.06)fl]and group B[(92.06±10.63)g/L,(27.19±3.05)fl],and the differences were statistically significant(P<0.05).At 3 d after surgery,Hb(95.26±9.19)g/L and MCV(28.79±3.01)fl in group C were higher than those in group A[(85.17±9.05)g/L,(26.01±2.36)fl]and group B[(86.16±9.13)g/L,(26.13±2.51)fl],and the differences were statistically significant(P<0.05).The postoperative complication rates 3.33%in group C was lower than 23.33%in group A and 20.00%in group B,and the difference was statistically significant(P<0.05).Conclusion Multiple intravenous injections of tranexamic acid is more beneficial to improve the hemostasis effect and reduce the complication rates of femoral neck fractures patients undergoing total hip arthroplasty.
作者
高猛
GAO Meng(Changqing District People’s Hospital,Jinan 250300,China)
出处
《中国实用医药》
2021年第27期18-20,共3页
China Practical Medicine
关键词
股骨颈骨折
全髋关节置换术
氨甲环酸
不同给药途径
止血
Femoral neck fractures
Total hip arthroplasty
Tranexamic acid
Different routes of administration
Hemostasis
