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常规静脉注射氨甲环酸在全髋关节置换术中的价值:一项初步研究。

The Value of Routine Intravenous Tranexamic Acid in Total Hip Arthroplasty: A Preliminary Study.

作者信息

Chin J, Blackett J, Kieser D C, Frampton C, Hooper G

机构信息

Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand.

出版信息

Adv Orthop. 2020 Feb 11;2020:2943827. doi: 10.1155/2020/2943827. eCollection 2020.

Abstract

OBJECTIVE

To determine the effect on the need for transfusion when intravenous tranexamic acid (TXA) is administered intraoperatively in patients undergoing total hip arthroplasty (THA).

METHOD

A prospective, double blinded, randomised control trial of 88 patients undergoing THA was randomly allocated to receive 1 g of intravenous TXA or normal saline on induction of anaesthesia. All patients received spinal anaesthesia. The primary outcome measure was transfusion rate, and the secondary outcomes were intraoperative blood loss, haemoglobin levels, length of hospital stay, functional scores, and thromboembolic complications.

RESULTS

19.0% of patients given TXA required a blood transfusion, compared with 20.5% given placebo (=0.87). Secondary outcomes included mean intraoperative blood loss, which was 536.5 ml in the TXA group and 469.8 ml in the placebo group (=0.87). Secondary outcomes included mean intraoperative blood loss, which was 536.5 ml in the TXA group and 469.8 ml in the placebo group (=0.87). Secondary outcomes included mean intraoperative blood loss, which was 536.5 ml in the TXA group and 469.8 ml in the placebo group (=0.87). Secondary outcomes included mean intraoperative blood loss, which was 536.5 ml in the TXA group and 469.8 ml in the placebo group (=0.87). Secondary outcomes included mean intraoperative blood loss, which was 536.5 ml in the TXA group and 469.8 ml in the placebo group (=0.87). Secondary outcomes included mean intraoperative blood loss, which was 536.5 ml in the TXA group and 469.8 ml in the placebo group (.

CONCLUSIONS

1 g IV TXA administered on induction did not significantly reduce the need for blood transfusion, postoperative blood loss, functional scores, or the length of stay in patients undergoing THA. This trial is registered with ACTRN12610001065088.

摘要

目的

确定在全髋关节置换术(THA)患者术中静脉注射氨甲环酸(TXA)对输血需求的影响。

方法

一项针对88例行THA患者的前瞻性、双盲、随机对照试验,患者在麻醉诱导时被随机分配接受1克静脉注射TXA或生理盐水。所有患者均接受脊髓麻醉。主要结局指标是输血率,次要结局指标是术中失血量、血红蛋白水平、住院时间、功能评分和血栓栓塞并发症。

结果

接受TXA的患者中有19.0%需要输血,而接受安慰剂的患者为20.5%(P=0.87)。次要结局包括平均术中失血量,TXA组为536.5毫升,安慰剂组为469.8毫升(P=0.87)。次要结局包括平均术中失血量,TXA组为536.5毫升,安慰剂组为469.8毫升(P=0.87)。次要结局包括平均术中失血量,TXA组为536.5毫升,安慰剂组为469.8毫升(P=0.87)。次要结局包括平均术中失血量,TXA组为536.5毫升,安慰剂组为469.8毫升(P=0.87)。次要结局包括平均术中失血量,TXA组为536.5毫升,安慰剂组为469.8毫升(P=0.87)。次要结局包括平均术中失血量,TXA组为536.5毫升,安慰剂组为469.8毫升(P=0.87)。

结论

麻醉诱导时静脉注射1克TXA并不能显著降低THA患者的输血需求、术后失血量、功能评分或住院时间。本试验已在澳大利亚新西兰临床试验注册中心注册,注册号为ACTRN12610001065088。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afc6/7036088/8232eeb7e6a1/AORTH2020-2943827.001.jpg

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