在单阶段双侧全膝关节置换术中使用氨甲环酸降低红细胞输注率：一项回顾性审计。

Lower red cell transfusion rates with use of tranexamic acid in single-stage bilateral total knee arthroplasty: A retrospective audit.

作者信息

Aziz Muhammad, Mahmood Salman Bin, Lakdawala Riaz Hussain, Ahmad Tashfeen

机构信息

Medical College, Department of Surgery, Aga Khan University, Karachi, Pakistan.

Section of Orthopedics, Department of Surgery, Aga Khan University, Karachi, Pakistan.

出版信息

J Pak Med Assoc. 2016 Oct;66(Suppl 3)(10):S102-S105.

PMID:27895370

Abstract

Bilateral total knee arthroplasty (BTKA) patients may require blood transfusion which has its risks. Anti-fibrinolytic drugs such as aprotinin, aminocaproic acid and tranexamic acid (TXA) have reduced transfusion requirements in major surgery. This retrospective audit was performed to assess effectiveness of TXA in reducing blood transfusion rate in single-stage sequential BTKA cases operated by a single surgeon. Records of 91 patients given TXA and 80 controls who were operated before 2012 and not given TXA were reviewed. TXA was given 15mg/kg intravenously (IV) before tourniquet deflation and 3 hours postoperatively.Blood transfusion was done in 9(10%) patients in the TXA group compared to 20(25%)in the control group (p<0.01). One (1.25%) patient in the control group had non-fatal pulmonary embolism.TXA appeared to be effective in decreasing post-operative blood loss and requirement for blood transfusion after single-stage BTKA.

摘要

双侧全膝关节置换术（BTKA）患者可能需要输血，而输血存在风险。抗纤溶药物，如抑肽酶、氨基己酸和氨甲环酸（TXA），已降低了大手术中的输血需求。进行这项回顾性审计是为了评估氨甲环酸在降低由单一外科医生进行的单阶段序贯双侧全膝关节置换术病例中的输血率的有效性。回顾了2012年之前接受手术且未使用氨甲环酸的91例使用氨甲环酸的患者和80例对照患者的记录。在松开止血带前静脉注射（IV）15mg/kg氨甲环酸，并在术后3小时注射。氨甲环酸组有9例（10%）患者接受了输血，而对照组有20例（25%）（p<0.01）。对照组有1例（1.25%）患者发生非致命性肺栓塞。氨甲环酸似乎对减少单阶段双侧全膝关节置换术后的术后失血和输血需求有效。