在采用直接前路入路进行的全髋关节置换术中静脉使用氨甲环酸的输血率。
Transfusion rates with intravenous tranexamic acid in total hip arthroplasty performed using the direct anterior approach.
作者信息
Free Matthew D, Owen David H, Pascoe Edward, Allen Penny, Yang Luke, Harvie Paul
机构信息
1 Royal Hobart Hospital, Hobart, Tasmania, Australia.
2 Rural Clinic School, University of Tasmania, Burnie, Tasmania, Australia.
出版信息
Hip Int. 2019 Sep;29(5):511-515. doi: 10.1177/1120700018811310. Epub 2018 Nov 27.
INTRODUCTION
Tranexamic acid (TXA) has been shown to reduce blood loss and transfusion requirements in patients undergoing total hip arthroplasty (THA). Most studies have focused on TXA in THA performed using a posterior approach (PA) or lateral approach. The aim of this study was to analyse the efficacy of TXA in patients undergoing THA using the direct anterior approach (DAA).
PATIENTS AND METHODS
Using our institutional database, a retrospective analysis was conducted on consecutive primary THA performed for osteoarthritis to determine transfusion rates in patients undergoing THA with the DAA with and without TXA.
RESULTS
146 consecutive THA were performed using DAA: 83 (56.8%) patients had TXA and 63 (43.2%) did not have TXA. Among patients who had TXA, 1 patient required a blood transfusion compared to 7 patients among those who did not have TXA (1.2% vs. 11.12%, = 0.02). The relative risk of 0.11 (95% confidence interval 0.01-0.86) indicates an 89% reduction in the risk of requiring blood transfusion with TXA administration compared to no TXA.
CONCLUSION
TXA is effective in reducing blood transfusion requirements for patients undergoing DAA THA.
引言
氨甲环酸（TXA）已被证明可减少全髋关节置换术（THA）患者的失血量和输血需求。大多数研究集中在采用后入路（PA）或侧入路进行的THA中使用TXA的情况。本研究的目的是分析TXA在采用直接前路入路（DAA）进行THA的患者中的疗效。
患者与方法
利用我们机构的数据库，对因骨关节炎进行的连续初次THA进行回顾性分析，以确定在采用DAA且使用或未使用TXA的THA患者中的输血率。
结果
采用DAA连续进行了146例THA：83例（56.8%）患者使用了TXA，63例（43.2%）患者未使用TXA。在使用TXA的患者中，有1例需要输血，而在未使用TXA的患者中有7例需要输血（1.2%对11.12%，P = 0.02）。相对风险为0.11（95%置信区间0.01 - 0.86），表明与未使用TXA相比，使用TXA输血需求风险降低了89%。
结论
TXA可有效降低采用DAA进行THA患者的输血需求。
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