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加压固定技术联合氨甲环酸对初次全髋关节置换术手术时间及术中失血的影响

The Effects of Press-Fit Technique Combined with Tranexamic Acid on Duration of Surgery and Intraoperative Blood Loss in Primary Total Hip Arthroplasty.

作者信息

Çataltepe Aziz, Öznam Kadir

机构信息

Department of Orthopedic Surgery and Traumatology, Medipol University, Istanbul, TUR.

出版信息

Cureus. 2022 Apr 5;14(4):e23833. doi: 10.7759/cureus.23833. eCollection 2022 Apr.

Abstract

BACKGROUND

Prolonged operative time and blood loss may affect the success rate in total hip arthroplasty (THA). The aim of the current study was to evaluate the effects of the press-fit (PF) technique without screws combined with tranexamic acid (TXA) on operative time and intraoperative blood loss in THA.

METHODS

We retrospectively evaluated 114 hips treated with THA between March 2017 and January 2021 in this study. The patients were divided into three groups, including PF-TXA group, only PF group, and screw group. PF-TXA group received intravenous (IV) 1 g TXA 15 minutes before surgical incision, followed by a peri-articular 1 g/50 ml TXA. Only the PF group and screw group did not receive TXA. The primary outcome measures were operative time and intraoperative blood loss. Secondary outcomes included postoperative blood loss, hemoglobin and hematocrit levels, allogeneic blood transfusions, length of hospital stay, the Harris Hip Score (HHS), and thromboembolic complications.

RESULTS

Operative time was lower in the PF-TXA group than that in the only PF and the screw group (p=0.0001). Intraoperative blood loss was significantly different in the PF-TXA group compared with the only PF and the screw group (423 ml, 516 ml, and 534 ml; respectively). The patients who received the PF technique combined with TXA had significantly less hospital stay length than the only PF group and the screw group (p=0.021).

CONCLUSION

The findings obtained in this study suggest that although only the PF technique can provide a shorter operative time compared to using screws, less blood loss may not be obtained using this technique in THA. PF technique combined with TXA significantly decreased operation time and intraoperative blood loss as well as the length of hospital stay following primary THA.

摘要

背景

手术时间延长和失血可能会影响全髋关节置换术(THA)的成功率。本研究的目的是评估无螺钉的压配(PF)技术联合氨甲环酸(TXA)对THA手术时间和术中失血的影响。

方法

本研究回顾性评估了2017年3月至2021年1月期间接受THA治疗的114例髋关节。患者分为三组,包括PF-TXA组、单纯PF组和螺钉组。PF-TXA组在手术切口前15分钟静脉注射(IV)1 g TXA,随后关节周围注射1 g/50 ml TXA。单纯PF组和螺钉组未接受TXA。主要观察指标为手术时间和术中失血。次要结果包括术后失血、血红蛋白和血细胞比容水平、异体输血、住院时间、Harris髋关节评分(HHS)和血栓栓塞并发症。

结果

PF-TXA组的手术时间低于单纯PF组和螺钉组(p=0.0001)。PF-TXA组与单纯PF组和螺钉组相比,术中失血有显著差异(分别为423 ml、516 ml和534 ml)。接受PF技术联合TXA的患者住院时间明显短于单纯PF组和螺钉组(p=0.021)。

结论

本研究结果表明,虽然与使用螺钉相比,仅PF技术可缩短手术时间,但在THA中使用该技术可能无法减少失血。PF技术联合TXA可显著缩短初次THA后的手术时间、术中失血以及住院时间。

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本文引用的文献

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Operative Time Affects Short-Term Complications in Total Joint Arthroplasty.手术时间影响全关节置换术的短期并发症。
J Arthroplasty. 2017 Apr;32(4):1285-1291. doi: 10.1016/j.arth.2016.12.003. Epub 2016 Dec 14.
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Predicting Blood Loss in Total Knee and Hip Arthroplasty.预测全膝关节和髋关节置换术中的失血量。
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