Sucher Mark G, Giordani Mauro, Figoni Andrew, Nedopil Alexander J
Department of Orthopaedics, University of California, Davis 4860 Y Street, Suite 3800, Sacramento, California, 95817, USA.
School of Medicine, University of California, Davis Education Building, 4610 X Street, Sacramento, California, 95817, USA.
Int Orthop. 2016 Oct;40(10):2019-2023. doi: 10.1007/s00264-015-3103-1. Epub 2016 Jan 8.
To evaluate the peri-operative blood loss with the use of epsilon-aminocaproic acid (ε-ACA) in total hip arthroplasty (THA).
One hundred sixty patients treated with THA were followed; 5 g ε-ACA diluted in 100 ml normal saline was applied intra-operatively. Eighty patients not receiving ε-ACA (non ε-ACA group) and eighty patients receiving ε-ACA (ε-ACA group) were compared regarding blood loss, need of transfusion, and thrombo-embolic complications.
Blood loss (mean ± SD) for the non ε-ACA group was 1678 ± 515 ml and for the ε-ACA group 1403 ± 417 ml (p < 0.05). In the non ε-ACA group 23 patients needed blood transfusions compared to ten patients in the ε-ACA group (p < 0.05). Cost savings were $284.39 per patient. No patient in either group developed a thrombo-embolic complication.
This study demonstrates a significant reduction in peri-operative blood loss after THA with topically applied ε-ACA. The application of ε-ACA reduced costs by lowering transfusion rates and did not increase thrombo-embolic events. ε-ACA is safe and effective in reducing blood loss and cost-efficient in THA.
评估在全髋关节置换术（THA）中使用ε-氨基己酸（ε-ACA）时的围手术期失血量。
对160例行THA治疗的患者进行随访；术中应用5g ε-ACA稀释于100ml生理盐水中。比较80例未接受ε-ACA的患者（非ε-ACA组）和80例接受ε-ACA的患者（ε-ACA组）在失血量、输血需求和血栓栓塞并发症方面的情况。
非ε-ACA组的失血量（均值±标准差）为1678±515ml，ε-ACA组为1403±417ml（p<0.05）。非ε-ACA组有23例患者需要输血，而ε-ACA组为10例患者（p<0.05）。每位患者节省费用284.39美元。两组均无患者发生血栓栓塞并发症。
本研究表明，在THA中局部应用ε-ACA可显著减少围手术期失血量。ε-ACA的应用通过降低输血率降低了成本，且未增加血栓栓塞事件。ε-ACA在减少THA失血量方面安全有效且具有成本效益。
