| 氨甲环酸在全膝关节置换术围术期的应用效果分析 |
| 投稿时间：2021-02-20 修订日期：2021-04-30 点此下载全文 |
| 引用本文：平伟,王伟,宋巍,李盼红,刘小娟.氨甲环酸在全膝关节置换术围术期的应用效果分析[J].药学实践杂志,2021,39(4):362~365 |
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| 中文摘要:目的 分析氨甲环酸在全膝关节置换术围术期的应用效果。方法 以2018年12月至2020年3月本院关节外科收治的老年膝骨关节炎患者120例为研究对象，采用随机数字表法分为对照组和观察组，各60例。对照组采用全膝关节置换术进行治疗，观察组在全膝关节置换术的术中和术后分别使用氨甲环酸注射液进行治疗，均使用1次，两组术后均随访6个月。比较两组手术相关指标，术前和术后48 h凝血功能，术前和术后6个月膝关节功能，统计两组住院期间并发症发生情况。结果 观察组患者术中失血量、隐性失血量、术后引流量均低于对照组（P<0.05），且术后引流时间、创面干燥时间、创面愈合时间均短于对照组（P<0.05）。与术前比较，术后48 h两组凝血酶原时间（PT）、部分凝血活酶时间（APTT）和全血纤维蛋白原（FIB）比较，差异无统计学意义（P>0.05），组间比较，差异无统计学意义（P>0.05）。与术前比较，术后6个月两组疼痛情况、行走稳定情况、行走距离、行走辅助、伸屈情况、肌力水平得分均升高，观察组高于对照组（P<0.05）。观察组患者并发症总发生率为8.33%，对照组患者并发症总发生率为13.33%，组间比较，差异无统计学意义（P>0.05）。结论 氨甲环酸可有效减少老年膝骨关节炎患者全膝关节置换术中失血，降低术后引流量，缩短术后引流时间，促进创面愈合，同时改善患者膝关节功能，且对凝血功能影响小，术后并发症少。 |
| 中文关键词:膝骨关节炎 氨甲环酸 全膝关节置换术 老年 凝血功能 膝关节功能 |
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| The therapeutic effects of tranexamic acid in total knee arthroplasty during perioperative period |
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| Abstract:Objective To evaluate the application value of tranexamic acid in total knee arthroplasty.Methods 120 elderly patients with knee osteoarthritis admitted to Department of Joint Surgery in our hospital from December 2018 to March 2020 were selected as study subjects. They were divided into the control group and the observation group by random number table method, with 60 patients in each group. The control group was treated with total knee arthroplasty. The observation group received one tranexamic acid injection during and after total knee arthroplasty. Both groups were followed up for 6 months after the operation. The operation-related indexes in two groups, preoperative and postoperative coagulation function 48 h after operation, preoperative and postoperative knee joint function 6 months after operation were compared. The incidence of complications during hospitalization in the two groups was counted.Results The intraoperative blood loss, hidden blood loss and postoperative drainage volume of the observation group were lower than those in the control group (P<0.05). The postoperative drainage time, drying time and wound healing time in the observation group were all shorter than those in the control group (P<0.05). There was no significant difference in prothrombin time (PT), partial thromboplastin time (APTT) and whole blood fibrinogen (FIB) between two groups before the surgery and 48 h after operation (P>0.05). No statistically significant difference was observed between the two groups (P>0.05). Compared with those before operation, the pain, walking stability, walking distance, walking assistance, flexor extension and muscle strength scores of the subjects in the two groups increased 6 months after the operation. The index scores in the observation group were higher than those in the control group (P<0.05). During the treatment, the total complication rate was 8.33% in the observation group and 13.33% in the control group, with no statistically significant difference between the two groups (P>0.05).Conclusion Tranexamic acid can effectively reduce blood loss, postoperative drainage volume, and postoperative drainage time in total knee arthroplasty for elderly patients with knee osteoarthritis. It promotes wound healing, improves knee joint function, and has little effect on coagulation function and less postoperative complications. |
| keywords:knee osteoarthritis tranexamic acid total knee arthroplasty elderly coagulation function knee joint function |
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