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口服加局部应用与单纯局部应用氨甲环酸对初次全髋关节置换术中失血及术后输血的影响。

Effect of Oral + Topical and Only Topical Tranaxamic Acid Application on Blood Loss and Postoperative Transfusion in Primary Total Hip Arthroplasty.

作者信息

Mutlu Tansel, Arıcan Mehmet, Karaduman Zekeriya Okan, Turhan Yalçın, Kaban İlyas, Dalaslan Raşit Emin, Sağlam Sönmez, Yücel Mücahid Osman

机构信息

Department of Orthopedics and Traumatology, Gebze Medical Park Hospital, Kocaeli 41400, Türkiye.

Department of Orthopedics and Traumatology, Faculty of Medicine, Duzce University, Duzce 81620, Türkiye.

出版信息

J Clin Med. 2025 Feb 14;14(4):1275. doi: 10.3390/jcm14041275.

Abstract

: Total hip arthroplasty is one of the most common procedures performed to reduce pain and improve hip functions in patients with advanced hip osteoarthritis, but perioperative blood loss, acute anemia and transfusion requirement increase the risk of morbidity and mortality during and after surgery and negatively affect functional recovery. We aimed to present the comparative results of oral + topical and only topical tranexamic acid application to reduce blood loss and postoperative transfusion in primary total hip arthroplasty. : We retrospectively evaluated the patients who applied to the Orthopedics and Traumatology outpatient clinic with complaints of hip pain and limited movement between January 2014 and December 2020, who underwent primary total hip arthroplasty with the diagnosis of coxarthrosis and who were administered oral + topical and only topical tranexamic acid before and during surgery, in terms of blood loss and transfusion requirement. : No statistically significant difference was observed between the preoperative, day 0 and day 1 hemoglobin means in those that were applied oral + topical tranexamic acid and those that were applied only topical ( > 0.05). However, the second- and third-day hemoglobin means in those that were treated with topical medication alone were found to be statistically significantly lower than in those that were treated with oral + topical tranexamic acid ( = 0.032, = 0.0001). : Oral + topical tranexamic acid application in total hip arthroplasty surgery is more effective than topical applications alone when it comes to reducing blood loss, hemoglobin and hematocrit decrease without increasing the risk of thromboembolic diseases and wound complications.

摘要

全髋关节置换术是为减轻晚期髋关节骨关节炎患者疼痛并改善髋关节功能而实施的最常见手术之一,但围手术期失血、急性贫血和输血需求会增加手术期间及术后发病和死亡风险,并对功能恢复产生负面影响。我们旨在呈现口服 + 局部应用与仅局部应用氨甲环酸在初次全髋关节置换术中减少失血和术后输血方面的对比结果。:我们回顾性评估了2014年1月至2020年12月期间因髋关节疼痛和活动受限而到骨科和创伤科门诊就诊、诊断为髋关节病并在手术前及手术期间接受口服 + 局部应用和仅局部应用氨甲环酸的初次全髋关节置换术患者的失血和输血需求情况。:口服 + 局部应用氨甲环酸组与仅局部应用氨甲环酸组在术前、术后第0天和第1天的血红蛋白均值之间未观察到统计学显著差异(>0.05)。然而,单独接受局部用药治疗的患者在术后第二天和第三天的血红蛋白均值在统计学上显著低于接受口服 + 局部应用氨甲环酸治疗的患者(=0.032,=0.0001)。:在全髋关节置换手术中,口服 + 局部应用氨甲环酸在减少失血、血红蛋白和血细胞比容降低方面比单独局部应用更有效,且不会增加血栓栓塞性疾病和伤口并发症的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03fc/11856408/b77728af5671/jcm-14-01275-g001.jpg

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