全髋关节和膝关节置换术中静脉注射与局部应用氨甲环酸的成本、疗效及安全性比较
Comparing Cost, Efficacy, and Safety of Intravenous and Topical Tranexamic Acid in Total Hip and Knee Arthroplasty.
作者信息
DiBlasi Joseph F, Smith Ross P, Garavaglia Jeffrey, Quedado Jeffrey, Frye Benjamin M, Dietz Matthew J
机构信息
Department of Orthopaedics, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, Morgantown, West Virginia.
出版信息
Am J Orthop (Belle Mead NJ). 2016 Nov/Dec;45(7):E439-E443.
Abstract
We conducted a study to compare the cost, efficacy, and safety of intravenous (IV) tranexamic acid (TXA) and topical TXA in primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). We retrospectively reviewed the cases of 291 patients who received either IV TXA or topical TXA before and after surgery. Significant differences favored topical TXA in reducing the postoperative decrease in hemoglobin levels in THA (P = .031) and TKA (P = .015) and calculated blood loss in TKA (P = .019). The groups did not differ in transfusion requirements for either THA or TKA. Topical TXA cost significantly more than IV TXA (P ≤ .0001). The benefits of using topical TXA to reduce the perioperative decrease in hemoglobin levels come with increased cost.
摘要
我们进行了一项研究，以比较静脉注射氨甲环酸（TXA）和局部应用TXA在初次全髋关节置换术（THA）和全膝关节置换术（TKA）中的成本、疗效和安全性。我们回顾性分析了291例在手术前后接受静脉注射TXA或局部应用TXA的患者病例。在THA（P = 0.031）和TKA（P = 0.015）中，局部应用TXA在减少术后血红蛋白水平下降方面有显著优势，在TKA中计算得出的失血量方面也有显著优势（P = 0.019）。THA或TKA的输血需求在两组之间没有差异。局部应用TXA的成本显著高于静脉注射TXA（P≤0.0001）。使用局部应用TXA来减少围手术期血红蛋白水平下降的益处伴随着成本的增加。
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