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氨甲环酸在初次全髋关节置换术中的临床经验。

Clinical experience with tranexamic acid during primary total hip arthroplasty.

作者信息

March Gerard M, Elfatori Salah, Beaulé Paul E

机构信息

Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.

出版信息

Hip Int. 2013 Jan-Feb;23(1):72-9. doi: 10.5301/HIP.2013.10724.

Abstract

We examined whether a single 1-gram preoperative dose of tranexamic acid (TXA) was effective in reducing 1) allogeneic blood transfusion, 2) haemoglobin (Hb) decreases, and 3) perioperative blood loss following primary total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA). One hundred and thirty-two patients (88 THA, 44 RHA; 66M, 66F; mean age = 58.2 years) who received TXA were compared with a control group matched for starting Hb, body mass index (BMI), age and gender. For the THR, transfusion rates were 4.5% and 19.3% for the TXA and control groups, respectively (p = 0.001) with no difference for the resurfacing patients. The mean overall Hb decrease was significantly lower in the TXA treatment groups for both THA and RHA patients (p<0.0001 and p = 0.01 respectively). 1 g of tranexamic acid administered preoperatively significantly reduced the mean decrease in haemoglobin as well as risk of transfusion.

摘要

我们研究了术前单次给予1克氨甲环酸(TXA)是否能有效减少:1)异体输血;2)血红蛋白(Hb)下降;3)初次全髋关节置换术(THA)和髋关节表面置换术(RHA)后的围手术期失血。将132例接受TXA治疗的患者(88例THA,44例RHA;66例男性,66例女性;平均年龄=58.2岁)与一组在起始Hb、体重指数(BMI)、年龄和性别方面相匹配的对照组进行比较。对于THR,TXA组和对照组的输血率分别为4.5%和19.3%(p=0.001),而表面置换患者两组间无差异。对于THA和RHA患者,TXA治疗组的平均总体Hb下降均显著更低(分别为p<0.0001和p=0.01)。术前给予1克氨甲环酸可显著降低血红蛋白的平均下降幅度以及输血风险。

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