不同途径应用氨甲环酸对初次全髋关节置换术患者有效性及近期安全性研究

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Abstract Objective To investigate the application of two different routes of administration of Tranexamic Acid on the blood loss and its safety in patients with initial unilateral total hip arthroplasty (THA). Methods 90 patients with femoral head necrosis who need to undergo initial unilateral THA in He'nan Luoyang Orthopedic Traumatological Hospital were randomly divided into three groups by STATA software from October 2014 to August 2016 in Luoyang Orthopedic Hospital of He'nan. They were group A (staticly drop Tranexamic Acid before 10 minutes of the surgery), group B (injecting Tranexamic Acid after completion of surgery) and group C (without using Tranexamic Acid). The three groups of blood loss, postoperative drainage, invisible blood loss, total blood volume, the number of blood transfusions after surgery, blood transfusion and transfusion rate, the rate of deep vein thrombosis and pulmonary embolism after one week and one month follow-up were compared. Results The quantity of postoperative drainage, invisible blood loss, total blood volume, the number of blood transfusions after surgery, blood transfusion and transfusion rate differences were statistically significant (P < 0.05) among three groups, and the blood loss in the surgery had no statistically significant difference (P > 0. 05). Patients in the group C respectively 2 and 4 days after the surgery in 1 case between limb muscle, vein thrombosis and 2 cases of limb phil superficial vein thrombosis, pulmonary embolism was not occurred, who were timely received symptomatic treatment, with leaving hospital improved, after 1 month reviewing, color Doppler ultrasound prompted that the venous thrombosis had disappeared. The patients of group A and group B had not lower limb venous thrombosis and pulmonary embolism in postoperative 1 week and followed up for 1 month. Conclusion Preoperative intravenous and retrograde injection through the drainage tube application of Tranexamic Acid can significantly reduce the primary unilateral total hip arthroplasty in patients with postoperative blood loss and transfusion rate, and the recent security is a very high, and local injections of Tranexamic Acid is more safe and effective, without postoperative adverse reactions and complications.

Key words： Total hip arthroplasty Blood loss Tranexamic Acid Security

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	FAN Ya'nan1 WEN Yangyang1 ZHANG Leilei2 LI Wenlong1 ZHU Yingjie2 LIU Youwen2

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FAN Ya'nan1 WEN Yangyang1 ZHANG Leilei2 LI Wenlong1 ZHU Yingjie2 LIU Youwen2. Effectiveness and safety of different application route of Tranexamic Acid in patients undergoing primary total hip arthroplasty[J]. 中国医药导报, 2017, 14(21): 97-100,116.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I21/97

[1] Mednick RE，Alvi HM，Krishnan V，et al. Factors affecting readmission rates following primary total hip arthroplasty [J]. J Bone Joint Surg Am，2014，96（14）：1201-1209.
[2] Gibon E，Courpied JP，Hamadouche M. Total joint replacement and blood loss：what is the best equation [J]. Int Orthop，2013，37（4）：735-739.
[3] Bierbaum BE，Callaghan JJ，Galante JO，et al. An analysis of blood management in patients having a total hip or knee arthroplasty [J]. J Bone Joint Surg Am，1999，81（1）：2-10．
[4] Dhir A. Antifibrinolytics in cardiac surgery [J]. Ann Card Anaesth，2013，16（2）：117-125.
[5] 徐红党.氨甲环酸和富血小板血浆对A型主动脉夹层手术患者的血液保护作用[D].郑州：郑州大学，2016.
[6] Patel J，Prajapati M，Patel H，et al. Topical and low-dose intravenous tranexamic acid in cyanotic cardiac surgery [J]. Asian Cardiovasc Thorac Ann，2017，25（2）：118-122.
[7] Alshryda S，Mason J，Vaqhela M，et al. Topical（intra-articular）tranexamic acidreduces blood loss and transfusion rates following total knee replacement：a randomized controlled trial [J]. J Bone Joint Surg Am，2013，95（21）：1961-1968.
[8] 何峥峰，颜廷卫.局部应用氨甲环酸对全髋关节置换术术后出血有效性和安全性的Meta分析[J].中国矫形外科杂志，2016，24（19）：1780-1786.
[9] Nadler SB，Hidalgo JU，Bloch T. Prediction of blood volume in normal human adults [J]. Surgery，1962，51（2）：224.
[10] Sehat KR，Evans RL，Newman JH. Hidden blood loss following hip and knee arthroplasty Correct management of blood loss should take hidden loss into account [J]. J Bone Joint Surg Br，2004，86（4）：561-565.
[11] Liu X，Zhang X，Chen Y，et al. Hidden blood loss after total hip arthroplasty [J]. J Arthroplasty，2013，26（7）：1100-1105．
[12] Syrovets T，Lunov O，Simmet T. Plasmin as a proinflammatory cell activator [J]. J Leukocyte Biol，2012，92（3）：509-519．
[13] Demos HA，Lin ZX，Barfield WR，et al. Process Improvement project using tranexamic acid is cost-effective in reducing blood loss and transfusions after total hip and total knee arthroplasty [J]. J Arthroplasty，2017. DOI：10.1016/j.arth.2017.02.068.
[14] 傅峥，张健，姚海.氨甲环酸对全髋关节置换术隐性失血的影响[J].重庆医科大学学报，2012，37（4）：359-361.
[15] 董锋，严实，禄代锋，等.氨甲环酸对老年股骨颈骨折行全髋关节置换术围手术期失血的疗效分析[J].哈尔滨医科大学学报，2015，49（4）：331-334.
[16] Alshryda S，Mason J，Sarda P，et al. Topical（intra-articular）tranexamic acid reduces blood loss and transfusion rates following total hip replacement：a randomized controlled trial （TRANX-H）[J]. J Bone Joint Surg Am，2013，95（21）：1969-1974.
[17] Clave A，Fazilleau F，Dumser D，et al. Efficacy of tranexamic acid on blood loss after primary cementless total hip replacement with rivaroxaban thromboprophy-laxis：a case-control study in 70 patients [J]. Orthop Traumatol Surg Res，2012，98（5）：484-490.
[18] Gilbody J，Dhotar HS，Perruccio AV，et al. Topical tranexamic acid reduces transfusion rates in total hip and knee arthroplasty [J]. J Arthroplasty，2014，29（4）：681-684.
[19] Konig G，Hamlin BR，Waters JH. Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty [J]. J Arthroplasty，2013，28（9）：1473-1476.
[20] Wei W，Wei B. Comparison of topical and intravenous Tranexamic acid on blood loss and transfusion rates in total hip Arthroplasty [J]. J Arthroplast，2014，29（11）：2113-2116.