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局部应用氨甲环酸减少老年股骨转子间骨折PFNA术患者围手术期失血的效果及安全性研究(PDF)

《创伤外科杂志》[ISSN:/CN:]

期数:
2020年10期
页码:
757-761
栏目:
论著·临床研究
出版日期:
2020-10-20

文章信息/Info

Title:
Effect and safety of topical application of tranexamic acid in reducing perioperative blood loss in elderly patients with intertrochanteric fracture treated with PFNA
文章编号:
1009-4237(2020)10-0757-05
作者:
江 维; 沈皆亮; 罗 刚
400016 重庆,重庆医科大学附属第一医院骨科
Author(s):
JIANG Wei; SHEN Jie-liang; LUO Gang
Department of Orthopaedics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China
关键词:
股骨转子间骨折;  出血;  氨甲环酸;  髓内钉;  围术期;  老年
分类号:
R 683.42
DOI:
10.3969/j.issn.1009-4237.2020.10.008
文献标识码:
A
摘要:
目的 探讨局部应用氨甲环酸(TXA)减少老年股骨转子间骨折股骨近端防旋髓内钉(PFNA)术患者围手术期失血的效果及安全性。方法 回顾性分析2016年3月—2018年3月重庆医科大学附属第一医院骨科因跌倒致股骨转子间骨折行PFNA治疗的235例患者,对术前的基本信息和临床指标的基准水平进行倾向评分匹配后分为TXA组91例(男性31例,女性60例; 年龄70～91岁,平均80.5岁)和对照组91例(男性29例,女性62例; 年龄71～89岁,平均79.8岁)。TXA组在大转子暴露后和切口闭合前分别用3g/100mL TXA溶液浸泡切口5min,对照组切口内无特殊处理。比较两组术中失血量、术后引流量、总失血量及隐性失血量、术后输血量及并发症发生率。结果 TXA组术中失血量、术后引流量、总失血量及隐性失血量均显著少于对照组[(119.5±62.4)mL vs.(165.3±71.5)mL、(109.7±55.7)mL vs.(198.5±68.5)mL、(547.3±193.7)mL vs.(822.2±271.8)mL、(431.8±192.7)mL vs.(677.3±283.6)mL,P<0.05]。TXA组输血量及输血率均显著低于对照组[(112.8±70.7)mL vs.(218.6±89.6)mL、18.7% vs. 41.8%,P<0.05]。两组围手术期凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)及D-二聚体(D-D)比较差异无统计学意义(P>0.05); 两组术后深静脉血栓、肺栓塞、伤口感染、心肌梗死及脑血管并发症发生率差异无统计学意义(P>0.05); 术后1年内病死率、1个月内再入院率及骨折愈合率差异无统计学意义(P>0.05)。结论 局部应用TXA能有效、安全地减少高龄股骨转子间骨折行PFNA手术患者围手术期失血量,减少输血量。

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备注/Memo

备注/Memo:
【通信作者】 罗刚,E-mail:luo_gang_lg@163.com
更新日期/Last Update: 2020-10-20