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氨甲环酸在关节镜下治疗股骨髋臼撞击症中的临床效果

[Clinical effects of tranexamic acid in arthroscope for femoroacetabular impingement].

作者信息

Li Ning, Qin Li-Wu, Jiang Hong-Jiang

机构信息

Department of Sport Medicine, Shandong Wendeng Orthopaedics Hospital, Weihai 264400, Shandong, China.

出版信息

Zhongguo Gu Shang. 2021 Feb 25;34(2):121-5. doi: 10.12200/j.issn.1003-0034.2021.02.005.

Abstract

OBJECTIVE

To evaluate the clinical effects of tranexamic acid in arthroscope for femoroacetabular impingement.

METHODS

Totally 34 patients (34 hips) with femoroacetabular impingement underwent hip arthroscopy from June 2016 to December 2018, were randomly divided into two groups named as tranexamic acid group and control group, 17 patients in each group. In TXA group, there were 10 males and 7 females, aged from 20 to 49 years old with an average of (32.1±7.6) years old;15 mg/kg TXA was intravenous drops before operation incision performed at 10 min. In control group, there were 11 males and 6 females, aged from 20 to 49 years old with an average of (30.9±6.2) years old;100 ml normal saline was intravenous drops before operation incision performed at 10 min. Introopertaive and total bloodloss between two groups were compared. Visual analogue scale (VAS) at 3 and 7 days after opertaion were used to evaluate pain relief of hip joint. Modified Harris Hip Score(mHHS) of hip joint at 3, 6, 9 and 12 weeks after oeprtaion were applied to evaluate clinical effects.

RESULTS

All patients were obtained follow up over 12 weeks. Incision healed well without infection and deep vein thrombosis. There were no statistical difference in opertaion time bewteen two groups(>0.05) . Total blood loss and introopertaive blood loss in TXA group were (0.47±0.20) L and (0.18±0.08) L, while (0.66±0.22) L and (0.24±0.01) L in control group;there were statical differences between two groups (<0.05). There were no dierences in VAS before opertaion and 7 days after opertaion between two groups (>0.05);VAS at 3 days after opertaion in TXA group was 2.35±1.12 and 3.12±0.70 in control group, and had difference (< 0.05). There were significance in VAS at 3 and 7 days after opertaion compared with preopertaive between two groups (< 0.05). Postopertaive mHHS in TXA group at 3 and 6 weeks were 87.72±1.95 and 91.92±2.32, respectively;while 84.08±1.21 and 89.77±3.30 in control group;there were difference between two groups at 3 and 6 weeks after operation (<0.05);there were no significant difference in mHHS between two groups at 9 and 12 weeks after operation(>0.05).

CONCLUSION

Preoperative application of tranexamic acid could effectively reduce blood loss in arthroscopy for femoroacetabular impingement, thereby improving surgical field of vision, reducing difficulty of surgical operation, which could promote early and rapid rehabilitation of hip function.

摘要

目的

评估氨甲环酸在关节镜下治疗股骨髋臼撞击症中的临床效果。

方法

选取2016年6月至2018年12月期间接受髋关节镜手术的34例(34髋)股骨髋臼撞击症患者,随机分为氨甲环酸组和对照组,每组17例。氨甲环酸组中,男10例,女7例,年龄20~49岁,平均(32.1±7.6)岁;术前10 min静脉滴注15 mg/kg氨甲环酸。对照组中,男11例,女6例,年龄20~49岁,平均(30.9±6.2)岁;术前10 min静脉滴注100 ml生理盐水。比较两组术中及总失血量。采用视觉模拟评分法(VAS)评估术后3 d和7 d时髋关节疼痛缓解情况。应用改良Harris髋关节评分(mHHS)评估术后3、6、9和12周时髋关节的临床效果。

结果

所有患者均获随访12周以上。切口愈合良好,无感染及深静脉血栓形成。两组手术时间比较,差异无统计学意义(>0.05)。氨甲环酸组总失血量和术中失血量分别为(0.47±0.20)L和(0.18±0.08)L,对照组分别为(0.66±0.22)L和(0.24±0.01)L;两组比较,差异有统计学意义(<0.05)。两组术前及术后7 d的VAS评分比较,差异无统计学意义(>0.05);氨甲环酸组术后3 d的VAS评分为2.35±1.12,对照组为3.12±0.70,差异有统计学意义(<0.05)。两组术后3 d和7 d的VAS评分与术前比较,差异有统计学意义(<0.05)。氨甲环酸组术后3周和6周的mHHS评分分别为87.72±1.95和91.92±2.32,对照组分别为84.08±1.21和89.77±3.30;术后3周和6周两组比较,差异有统计学意义(<0.05);术后9周和12周两组mHHS评分比较,差异无统计学意义(>0.05)。

结论

术前应用氨甲环酸可有效减少股骨髋臼撞击症关节镜手术中的出血量,从而改善手术视野,降低手术操作难度,促进髋关节功能早期快速康复。

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