氨甲环酸对全关节置换术患者有益，无论术前血红蛋白值如何。
Tranexamic Acid Benefits Total Joint Arthroplasty Patients Regardless of Preoperative Hemoglobin Value.
作者信息
Whiting Daniel R, Duncan Christopher M, Sierra Rafael J, Smith Hugh M
机构信息
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.
出版信息
J Arthroplasty. 2015 Dec;30(12):2098-101. doi: 10.1016/j.arth.2015.05.050. Epub 2015 Jun 3.
While tranexamic acid (TXA) reduces transfusion in total joint arthroplasty (TJA), it remains unclear whether there is a preoperative hemoglobin (Hgb) threshold above which it is no longer beneficial. 2100 primary TJA patients were retrospectively categorized by preoperative Hgb; 1161 (55%) received TXA. Transfusion rates decreased with TXA in all groups; with Hgb>15 the transfusion rate was 0.5% with TXA and 4.5% without (P=0.0086); with Hgb>11 the transfusion rate was 4.7% with TXA and 18.7% without (P<0.0001). Patients receiving TXA had a shorter LOS by 0.51 days (P<0.0001). Patients receiving a postoperative transfusion had a longer LOS by 0.69 days (P<0.0001). TXA should be considered in all TJA patients independent of preoperative Hgb level.
虽然氨甲环酸（TXA）可减少全关节置换术（TJA）中的输血，但术前血红蛋白（Hgb）是否存在一个阈值，高于此阈值TXA便不再有益，目前尚不清楚。对2100例初次TJA患者按术前Hgb进行回顾性分类；1161例（55%）接受了TXA治疗。所有组中TXA治疗的输血率均降低；Hgb>15时，TXA治疗组输血率为0.5%，未接受TXA治疗组为4.5%（P=0.0086）；Hgb>11时，TXA治疗组输血率为4.7%，未接受TXA治疗组为18.7%（P<0.0001）。接受TXA治疗的患者住院时间缩短0.51天（P<0.0001）。接受术后输血的患者住院时间延长0.69天（P<0.0001）。所有TJA患者均应考虑使用TXA，而不考虑术前Hgb水平。
Zotero 插件