Oliveira José Alberto Alves, Brito Gabriella Cristina Coelho DE, Bezerra Francisca Magna Prado, Carvalho Carlos Alfredo DE, Alencar Jonatas Brito DE, Ibiapina Roberto César Pontes
Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
Hospital Infantil Albert Sabin, Fortaleza, Ceará, Brazil.
Acta Ortop Bras. 2021 Nov-Dec;29(6):304-307. doi: 10.1590/1413-785220212906244502.
To evaluate the use of tranexamic acid (TXA) and ε-aminocaproic acid (EACA) in reducing blood loss in hip and proximal femur trauma surgery.
Prospective study with 49 patients surgically treated in a trauma hospital between Nov/2015 and Feb/2017. The patients were divided in two groups: TXA (n = 24) and EACA (n = 25). The comparison was made according to gender, age at the time of surgery, ASA, fracture and surgery type, estimated blood loss during surgical approach, hemoglobin and hematocrit levels pre and post-operative, and pharmacological cost. The data was processed using SPSS 22.0 with significance level of p < 0,05.
No significant difference was found in the variables age, gender, ASA and estimated blood loss during surgical approach. No patient needed blood transfusion. When evaluated post-operatively, the hemoglobin and hematocrit values decrease had no significant difference between the antifibrinolytics (p > 0.05). When analyzing total cost for both pharmacological agents, higher cost was observed in EACA than in TXA (US$ 16.09 - US$ 2.73), resulting in a US$ 13.36 addition per patient.
Antifibrinolytic use was efficient on lowering the total blood loss, without the need of blood transfusion.
评估氨甲环酸（TXA）和ε-氨基己酸（EACA）在减少髋部和股骨近端创伤手术失血中的应用。
对2015年11月至2017年2月期间在一家创伤医院接受手术治疗的49例患者进行前瞻性研究。患者分为两组：TXA组（n = 24）和EACA组（n = 25）。根据性别、手术时年龄、美国麻醉医师协会（ASA）分级、骨折和手术类型、手术入路期间估计失血量、术前和术后血红蛋白及血细胞比容水平以及药物成本进行比较。数据使用SPSS 22.0进行处理，显著性水平为p < 0.05。
在年龄、性别、ASA分级和手术入路期间估计失血量等变量上未发现显著差异。没有患者需要输血。术后评估时，抗纤溶药物之间血红蛋白和血细胞比容值的降低没有显著差异（p > 0.05）。在分析两种药物的总成本时，发现EACA的成本高于TXA（16.09美元 - 2.73美元），每位患者增加了13.36美元。
使用抗纤溶药物在降低总失血量方面是有效的，且无需输血。
