氨甲环酸在全膝关节置换术中的应用进展Application of tranexamic acid in total knee arthroplasty
吴洁;陈晓勇;朱锦宇;
摘要(Abstract):
全膝关节置换术(total knee arthroplasty,TKA)如今被应用的日益广泛,但是该手术围手术期常常会有大量出血而严重影响术后恢复。抗纤溶药物氨甲环酸(tranexamic acid,TXA)作为近年来许多学科纷纷采用的安全有效的止血剂,在国内外诸多研究中被证明在全膝关节置换术中应用也能安全有效的减少出血,从而减少输血率。本文拟对TKA围手术期使用TXA的血液保护机制、有效性、安全性、给药途径、给药剂量以及给药时机等加以综述。
关键词(KeyWords): 氨甲环酸;全膝关节置换术;血液保护;深静脉血栓
基金项目(Foundation):
作者(Author): 吴洁;陈晓勇;朱锦宇;
Email:
DOI:
参考文献(References):
- [1]Sarzaeem MM,Razi M,Kazemian G,et al.Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty[J].J Arthroplasty,2014,29(8):1521-1524.
- [2]傅德杰,陈凯宁,杨柳.氨甲环酸对全膝关节置换术失血量影响的系统评价[J].中国矫形外科杂志,2012,20(13):1172-1177.
- [3]Mc Cormack PL.Tranexamic acid:a review of its use in the treatment of hyperfibrinolysis[J].Drugs,2012,72(5):585-617.
- [4]Tengborn L,Blomback M,Berntorp E.Tranexamic acid-an old drug still going strong and making a revival[J].Thromb Res,2015,135(2):231-242.
- [5]Grassin-Delyle S,Tremey B,Abe E,et al.Population pharmacokinetics of tranexamic acid in adults undergoing cardiac surgery with cardiopulmonary bypass[J].Br J Anaesth,2013,111(6):916-924.
- [6]Draxler DF,Robert L.The fibrinolytic system-more than fibrinolysis[J].Transfus Med Rev,2014,29(2):102-109.
- [7]Later AF,Sitniakowsky LS,van Hilten JA,et al.Anti-brinolytics attenuate in flammatory gene expression after cardiac surgery[J].J Thorac Cardiovasc Surg,2013,145(6):1611-1616.
- [8]Shen Y,Guo Y,Mikus P,et al.Plasminogen is a key proinflammatory regulator that accelerates the healing of acute and diabetic wounds[J].Blood,2012,119(24):5879-5887.
- [9]Klak M,Anakkala N,Wang W,et al.Tranexamic acid,an inhibitor of plasminogen activation,aggravates staphylococcal septic arthritis and sepsis[J].Scand J Infect Dis,2010,42(5):351-358.
- [10]Poeran J,Rasul R,Suzuki S,et al.Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States:retrospective analysis of effectiveness and safety[J].Br Med J,2014,349(8):4829.
- [11]Wu Q,Zhang HA,Liu SL,et al.Is tranexamic acid clinically effective and safe to prevent blood loss in total knee arthroplasty?A meta-analysis of 34 randomized controlled trials[J].Eur J Orthop Surg Traumatol,2015,25(3):525-541.
- [12]Chen X,Zhu X,Yang S,et al.Tranexamic acid treatment decreases hidden blood loss in total knee arthroplasty[J/OL].Am J Ther,2015.PMID:25768379.
- [13]Samujh C,Falls TD,Wessel R,et al.Decreased blood transfusion following revision total knee arthroplasty using tranexamic acid[J].J Arthroplasty,2014,29(2):182-185.
- [14]Xie J,Ma J,Kanget P,et al.Does tranexamic acid alter the risk of thromboembolism following primary total knee arthroplasty with sequential earlier anticoagulation?A large,single center,prospective cohort study of consecutive cases[J].Thromb Res,2015,136(2):234-238.
- [15]Blake PG,Lori JD,Robert TT,et al.Low risk of thromboembolic complications with tranexamic acid after primary total hip and knee arthroplasty[J].Clin Orthop,2013,471(2):150-154.
- [16]Tuttle JR,Ritterman SA,Cassidy DB,et al.Cost benefit analysis of topical tranexamic acid in primary total hip and knee arthroplasty[J].J Arthroplasty,2014,29(8):1512-1515.
- [17]Whiting DR,Gillette BP,Duncan C,et al.Preliminary results suggest tranexamic acid is safe and effective in arthroplasty patients with severe comorbidities[J].Clin Orthop,2014,472(1):66-72.
- [18]Astedt B,Liedholm P,Wingerup L.The effect of tranexamic acid on the fibrinolytic activity of vein walls[J].Ann Chir Gynaecol,1978,67(2):203-205.
- [19]Benoni G,Lethagen S,Fredin H.The effect of tranexamic acid on local and plasma fibrinolysis during total knee arthroplasty[J].Thromb Res,1997,5(2):195-206.
- [20]Yang ZG,Chen WP,Wu LD.Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty:a meta-analysis[J].J Bone Joint Surg Am,2012,94(13):1153-1159.
- [21]Ahlberg A,Eriksson O,Kjellman H.Diffusion of tranexamic acid to the joint[J].Acta Orthop Scand,1976,47(5):486-488.
- [22]Mannucci PM.Hemostatic drugs[J].N Engl J Med,1998,339(4):245-253.
- [23]Chen ZY,Gao Y,Chen W,et al.Reduced blood loss after intra-articular tranexamic acid injection during total knee arthroplasty:a meta-analysis of the literature[J].Knee Surg Sports Traumatol Arthrosc,2014,22(12):3181-3190.
- [24]Kim TK,Chang CB,Koh IJ.Practical issues for the use of tranexamic acid in total knee arthroplasty:a systematic review[J].Knee Surg Sport Traumatol Arthrosc,2014,22(8):1849-1858.
- [25]Gandhi R,Evans H,Mahomed S,et al.Tranexamic acid and the reduction of blood loss in total knee and hip arthroplasty:a meta-analysis[J].BMC Res Notes,2013,6(2):184-188.
- [26]Iwai T,Tsuji S,Tomita T,et al.Repeat-dose intravenous tranexamic acid further decreases blood loss in total knee arthroplasty[J].Int Orthop,2013,37(3):441-445.
- [27]Blanie A,Bellamy L,Rhayem Y,et al.Duration of postoperative fibrinolysis after total hip or knee replacement:a laboratory follow-up study[J].Thromb Res,2013,131(1):6-11.