岳聚安;张启栋;郭晓忠;

• 1:航空总医院关节外科
• 2:中日友好医院关节外科

摘要(Abstract)：

[目的]探讨贫血患者膝单髁置换术使用氨甲环酸的临床效果。[方法]回顾性的分析2018年7月～2019年5月行单侧UKA患者术前贫血的临床资料。共有73例患者纳入本研究。按照是否使用氨甲环酸将患者分为TXA组34例,非TXA组39例。比较两组临床与辅助检查资料。[结果]两组患者均顺利手术,无严重并发症。两组在手术时间、止血带使用时间、切口长度、术中失血量的差异无统计学意义(P>0.05),但TXA术后引流量、显性失血量、隐性失血量、异体输血量显著少于非TXA组(P<0.05)。围手术期两组患者均无症状性血栓或肺栓塞。两组患者Hb和HCT术后1～3 d呈下降趋势,术后3 d均降至最低值,术后4～5 d恢复性上升(P<0.05)。术后各时间点TXA组的Hb和HCT均高于非TXA组,术后1 d时两组间差异有统计学意义(P<0.05),而术后2～5 d两组间差异无统计学意义(P>0.05)。超声检查显示,TXA组4例肌间血栓,非TXA组5例肌间血栓。[结论]静脉使用氨甲环酸可有效减少贫血患者UKA的失血量,降低输血率,而不增加深静脉血栓形成的风险。

关键词(KeyWords)： 单髁膝置换;贫血;氨甲环酸;失血;血栓

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(编号：81703896、81673776);; 首都卫生发展科研专项项目(编号：2016-2-4062);; 国家重点研发计划课题项目(编号：2017YFC0108102);; 北京市科技计划(首特)课题项目(编号：Z171100001017209)

作者(Author): 岳聚安;张启栋;郭晓忠;

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DOI:

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