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| 氨甲环酸关节腔用药与静脉用药在全膝关节置换老年患者中的疗效对比 |
| Efficacy comparison of articular injection and intravenous injection with tranexamic acid in total knee arthroplasty |
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| DOI：10.3969/j.issn.1006-7108.2019.12.025 |
| 中文关键词: 氨甲环酸 关节腔注射 静脉注射 全膝关节置换 老年患者 |
| 英文关键词:Tranexamic acid articular injection intravenous injection total knee arthroplasty |
| 基金项目:青海省自然科学基金（qh291234） |
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| 中文摘要: |
| 目的 观察全膝关节置换（total knee arthroplasty,TKA）患者采用关节腔注射和静脉注射氨甲环酸（tranexamic acid，TXA）的临床效果。方法 纳入我院2014年8月至2016年8月期间收治的90例TKA患者作为研究对象，按随机数字表法分为两组，每组45例。其中45例患者术中采用TXA静脉滴注治疗作为静脉组；另外45例患者术中采用TXA关节腔注射治疗作为关节腔组。观察两组患者手术时间、失血量、输血量、凝血功能、血红蛋白水平以及并发症情况。结果 两组患者手术时间和术中出血量并无差异，P＞0.05；关节腔组术后引流量及输血量均明显低于静脉组，P＜0.05。术前两组患者凝血功能水平及血红蛋白（Hb）水平无差异，P＞0.05；术后两组患者凝血功能水平及Hb水平仍无差异，P＞0.05。关节腔组、静脉组不良反应发生率分别为2.22%、13.33%，关节腔组明显低于静脉组，P＜0.05。结论 全膝关节置换中采用氨甲环酸关节腔注射可有效减少患者术后引流量和输血量，不良反应少，值得临床应用及推广。
关键词：氨甲环酸；关节腔注射；静脉注射；全膝关节置换；老年患者 |
| 英文摘要: |
| Objective To study the efficacy of articular injection and intravenous injection with tranexamic acid (TXA) in total knee arthroplasty (TKA). Methods 90 patients undergoing the TKA from August 2014 to August 2016 in our hospital were selected. The subjects were randomly assigned to intravenous injection group and articular injection group, 45 cases each group. Patients took the articular injection and intravenous injection with TXA, respectively. The operation time, bleeding volume, blood transfusion volume, coagulation function, hemoglobin levels and complications were explored. Results There were no significant between-group difference in the operation time and intraoperative bleeding volume (P＞0.05); the postoperative drainage volume and blood transfusion volume in the articular injection group were significantly smaller than intravenous injection group (P＜0.05); there was no significant between-group difference in the coagulation function (P＞0.05); after surgery, there was no significant between-group difference in the coagulation function (P＞0.05); the adverse event rate in the articular injection group was significantly lower than intravenous injection group (2.22% vs. 13.33%) (P＜0.05).Conclusion The articular injection of TXA can reduce the postoperative drainage volume, blood transfusion volume and adverse event rate. It is worthy of clinical application and promotion. |
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