[1]徐应朋,陈岩召.氨甲环酸对老年稳定型股骨粗隆间骨折围术期失血量影响[J].医学信息,2019,32(05):148-150.[doi:10.3969/j.issn.1006-1959.2019.05.047]
　XU Ying-peng,CHEN Yan-zhao.Effect of Tranexamic Acid on Perioperative Blood Loss in Elderly Patients with Stable Intertrochanteric Fracture[J].Medical Information,2019,32(05):148-150.[doi:10.3969/j.issn.1006-1959.2019.05.047]
点击复制

氨甲环酸对老年稳定型股骨粗隆间骨折围术期失血量影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年05期
页码:
148-150
栏目:
药物与临床
出版日期:
2019-03-01

文章信息/Info

Title:
Effect of Tranexamic Acid on Perioperative Blood Loss in Elderly Patients with Stable Intertrochanteric Fracture
文章编号:
1006-1959（2019）05-0148-03
作者:
徐应朋1; 陈岩召2
（1.湖北中医药大学，湖北 武汉 430065；2.中国人民解放军中部战区总医院骨科，湖北 武汉 430000）
Author(s):
XU Ying-peng1; CHEN Yan-zhao2
(1.Hubei University of Chinese Medicine,Wuhan 430065,Hubei,China;2.Orthopedics Department,Central Theater Command General Hospital of the Chinese People’s Liberation Army,Wuhan 430000, Hubei,China)
关键词:
氨甲环酸; 股骨粗隆间骨折; DHS; 失血
Keywords:
Tranexamic acid; Femoral intertrochanteric fracture; DHS; Blood loss
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2019.05.047
文献标志码:
A
摘要:
目的 评价术前静脉使用氨甲环酸（TXA）对老年稳定型股骨粗隆间骨折患者行动力髋螺钉（DHS）内固定围手术期失血量的影响。方法 回顾性分析2015年1月1日~2018年12月1日因股骨粗隆间骨折在中国人民解放军中部战区总医院骨科行DHS内固定的老年患者90例，根据患者围手术期是否使用TXA分为两组。对照组45例，术前术后均未给予TXA；实验组45例，术前15 min静脉滴注TXA 20 mg/kg。记录患者术前及术后第1、3、5天血红蛋白、红细胞压积、凝血功能，比较两组隐性失血量、显性失血量、围手术期总失血量、输血率，记录血栓性并发症发生情况。结果 实验组围手术期总失血量、隐性失血量、显性失血量分别为（614.42±62.92）ml、（149.74±59.23）ml、（465.32±96.33）ml，低于对照组的（844.81±75.51）ml、（187.72±83.13）ml、（657.63±83.61）ml，差异有统计学意义（P＜0.05）。实验组输血率为33.33%，低于对照组的60.00%，差异有统计学意义（P＜0.05）。两组患者术后均未出现肺栓塞及下肢深静脉血栓形成。结论 术前使用TXA可以减少DHS治疗股骨粗隆间骨折围手术期失血量和输血率，且不增加术后深静脉血栓风险。
Abstract:
Objective To evaluate the effect of preoperative intravenous tranexamic acid (TXA) on perioperative blood loss in patients with stable intertrochanteric fractures of the aged with mobility-hose screw (DHS). Methods A retrospective analysis of 90 elderly patients who underwent DHS in the Department of Orthopaedics of the Central Hospital of the Central People’s Liberation Army from January 1, 2015 to December 1, 2018, according to whether the patient used TXA during the perioperative period. Divided into two groups. In the control group, 45 patients were not given TXA before and after operation. In the experimental group, 45 patients received intravenous infusion of TXA 20 mg/kg 15 min before surgery. The patients were recorded for hemoglobin, hematocrit and coagulation function before and 1st, 3rd and 5th day after operation. The hidden blood loss, dominant blood loss, total perioperative blood loss and blood transfusion rate were recorded. The thrombotic concurrency was recorded. The occurrence of the disease. Results The total perioperative blood loss, recessive blood loss and dominant blood loss of the experimental group were (614.42±62.92) ml, (149.74±59.23) ml, (465.32±96.33) ml, which was lower than that of the control group (844.81±75.51) ml, (187.72±83.13) ml, (657.63±83.61) ml, the difference was statistically significant (P<0.05). The blood transfusion rate of the experimental group was 33.33%, which was lower than that of the control group 60.00%,the difference was statistically significant (P<0.05). There were no pulmonary embolism and deep venous thrombosis of the lower extremities in both groups. Conclusion Preoperative TXA can reduce the perioperative blood loss and blood transfusion rate of DHS in the treatment of intertrochanteric fractures without increasing the risk of postoperative deep vein thrombosis.

参考文献/References:


[1]杨红,谭洁,胡炜,等.PFNA与DHS内固定治疗老年股骨粗隆间骨折围术期失血量的比较[J].中国老年学杂志,2018,38(23):5736-5739.
[2]Georgiev GP,Tanchev PP,Zheleva Z,et al.Comparison of topical and intravenous administration of tranexamic acid for blood loss control during total joint replacement: Review of literature[J].J Orthop Translat,2018,13(12):7-12.
[3]岳辰,谢锦伟,蔡东峰,等.静脉联合局部应用氨甲环酸减少初次全髋关节置换术围手术期失血的有效性及安全性研究[J].中华骨与关节外科杂志,2015,8(1):44-48.
[4]Nadler SB,Hidalgo JH,Bloch T.Prediction of blood volume in normal human adults[J].Surgery,1962,51(2):224-232.
[5]Gross JB.Estimating allowable blood loss: corrected for dilution[J].Anesthesiology,1983,58(3):277-280.
[6]Puram C,Pradhan C,Patil A,et al.Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures[J].Injury,2017,48(Suppl 2):S72-S77.
[7]丁涛,张保焜,田少奇,等.老年髋部骨折手术方法的选择原则及应用现状[J].中国修复重建外科杂志,2018,32(11):1435-1440.
[8]袁磊,包倪荣,赵建宁.髋关节置换术后隐性失血的新进展[J].中国骨伤,2015,28(4):378-382.
[9]Zhu J,Zhu Y,Lei P,et al.Efficacy and safety of tranexamic acid in total hip replacement: A PRISMA-compliant meta-analysis of 25 randomized controlled trials[J].Medicine(Baltimore),2017,96(52):e9552.
[10]Li J,Zhang Z,Chen J.Comparison of efficacy and safety of topical versus intravenous tranexamic acid in total hip arthroplasty: A meta-analysis[J].Medicine(Baltimore),2016,95(36):e4689.
[11]史庆轩,梁晓松,李昊,等.局部应用氨甲环酸和止血纱布减少股骨粗隆间骨折手术失血[J].中国矫形外科杂志,2018,26(4):315-319.
[12]张连方,朱锋,周军,等.氨甲环酸减少股骨粗隆间骨折PFNA围术期失血[J].中国矫形外科杂志,2017,25(24):2248-2250.
[13]Abdel MP,Chalmers BP,Taunton MJ,et al.Intravenous Versus Topical Tranexamic Acid in Total Knee Arthroplasty: Both Effective in a Randomized Clinical Trial of 640 Patients[J].J Bone Joint Surg Am,2018,100(12):1023-1029.

相似文献/References:

[1]王尉霖,张 健.氨甲环酸在髋膝关节置换中的应用研究进展[J].医学信息,2018,31(07):39.[doi:10.3969/j.issn.1006-1959.2018.07.014]
　WANG Wei-lin,ZHANG Jian.Progress in the Study of Hip and Knee Replacement in Tranexamic Acid[J].Medical Information,2018,31(05):39.[doi:10.3969/j.issn.1006-1959.2018.07.014]
[2]庞永华,陈伟南,许科峰,等.TKA应用氨甲环酸后序贯应用两种新型口服抗凝药预防VTE的疗效对比[J].医学信息,2022,35(09):100.[doi:10.3969/j.issn.1006-1959.2022.09.025]
　PANG Yong-hua,CHEN Wei-nan,XU Ke-feng,et al.Comparison of Efficacy of Sequential Application of Two New Oral Anticoagulants in the Prevention of VTE After Application of Tranexamic Acid in TKA[J].Medical Information,2022,35(05):100.[doi:10.3969/j.issn.1006-1959.2022.09.025]
[3]吴 侃,李 黎,杨家赵,等.仰卧位与侧卧位下PFNA治疗老年股骨粗隆间骨折的 临床疗效比较[J].医学信息,2018,31(11):76.[doi:10.3969/j.issn.1006-1959.2018.11.024]
　WU Kan,LI Li,YANG Jia-zhao,et al.Comparison of Clinical Effects between Supine Position and Lateral Decubitus PFNA in the Treatment of Intertrochanteric Fractures in the Elderly[J].Medical Information,2018,31(05):76.[doi:10.3969/j.issn.1006-1959.2018.11.024]
[4]吕东升,陶 杰,朱先龙,等.PFNA与Gamma钉治疗不稳定股骨粗隆间骨折的 早期疗效评价[J].医学信息,2018,31(14):104.[doi:10.3969/j.issn.1006-1959.2018.14.030]
　LV Dong-sheng,TAO Jie,ZHU Xian-long,et al.Evaluation of the Early Curative Effect of PFNA and Gamma Nail in the Treatment of Unstable Intertrochanteric Fracture of Femur[J].Medical Information,2018,31(05):104.[doi:10.3969/j.issn.1006-1959.2018.14.030]
[5]陈 冲.PFNA与BFNR治疗老年股骨粗隆间骨折的临床疗效[J].医学信息,2019,32(11):111.[doi:10.3969/j.issn.1006-1959.2019.11.031]
　CHEN Chong.Therapeutic Effect of Proximal Femoral Nail and Artificial Bipolar Femoral Head Replacement for the Treatment of Intertrochanteric Fractures in the Elderly[J].Medical Information,2019,32(05):111.[doi:10.3969/j.issn.1006-1959.2019.11.031]
[6]杨利中,冯欢欢,刘 华,等.桃红四物汤联合氨甲环酸对人工股骨头置换术后 隐形失血的影响[J].医学信息,2019,32(17):150.[doi:10.3969/j.issn.1006-1959.2019.17.050]
　YANG Li-zhong,FENG Huan-huan,LIU Hua,et al.Effect of Taohong Siwu Decoction Combined with Tranexamic Acid on Invisible Blood Loss after Artificial Femoral Head Replacement[J].Medical Information,2019,32(05):150.[doi:10.3969/j.issn.1006-1959.2019.17.050]
[7]李宝柱.股骨粗隆间骨折PFNA内固定术后个性化 康复训练的效果研究[J].医学信息,2019,32(18):94.[doi:10.3969/j.issn.1006-1959.2019.18.030]
　LI Bao-zhu.Effect of Personalized Rehabilitation Training after PFNA Internal Fixation for Intertrochanteric Fractures[J].Medical Information,2019,32(05):94.[doi:10.3969/j.issn.1006-1959.2019.18.030]
[8]梁 周,黄 政,杨德炎,等.3D打印技术在股骨粗隆间骨折手术中的应用[J].医学信息,2019,32(19):68.[doi:10.3969/j.issn.1006-1959.2019.19.020]
　LIANG Zhou,HUANG Zheng,YANG De-yan,et al.Application of 3D Printing Technology in the Operation of Intertrochanteric Fracture[J].Medical Information,2019,32(05):68.[doi:10.3969/j.issn.1006-1959.2019.19.020]
[9]蔡 越,周媛苑.聚焦解决模式对老年股骨隆间骨折患者术后康复的影响[J].医学信息,2019,32(12):179.[doi:10.3969/j.issn.1006-1959.2019.12.061]
　CAI Yue,ZHOU Yuan-yuan.Effect of Solution Focused Approach on Postoperative Rehabilitation of Elderly Patients with Intertrochanteric Fracture[J].Medical Information,2019,32(05):179.[doi:10.3969/j.issn.1006-1959.2019.12.061]
[10]郜 鹏.股骨粗隆间骨折的治疗研究[J].医学信息,2022,35(16):163.[doi:10.3969/j.issn.1006-1959.2022.16.042]
　GAO Peng.Study on Treatment of Intertrochanteric Fracture of Femur[J].Medical Information,2022,35(05):163.[doi:10.3969/j.issn.1006-1959.2022.16.042]

更新日期/Last Update: 2019-03-01