| 摘要: |
| 目的：研究局部应用蛇毒血凝酶减少全髋关节置换术失血量的有效性及安全性。方法：选择行单侧全髋关节置换术的患者 45 例，随机分为 A、B、C 组。A 组不使用任何止血药物，B 组在缝合关节囊后向关节腔内注射 50 mL 的氨甲环酸，C 组在缝合关节囊后向关节腔内注射 12 mL 的蛇毒血凝酶注射液。统计、比较各组基本资料和血红蛋白、血小板、凝血常规及术中失血量、术后 24 h 引流量、输血率等指标，观察术后有无下肢深静脉血栓形成及肺部感染及切口感染等并发症。结果：3 组术中失血量、术后深静脉血栓形成及肺部感染、切口感染等并发症发生率差异无统计学意义（P>0.05）。术后 24 h 引流量 3 组分别为（396.7±139.5）mL、（303.3±91.5）mL、（206.7±106.7）mL，差异有统计学意义（P<0.05），输血率 3 组分别为 5/15、2/15、0，差异有统计学意义（P<0.05）；术后血红蛋白 3 组分别为（87.9±10.6）g/L，（96.9±10.7）g/L、（107.2±11.1）g/L，差异有统计学意义（P<0.05）；3 组手术前后凝血常规、血小板变化差异无统计学意义（P>0.05），均未出现血栓及肺部感染、切口感染等并发症。结论：局部应用蛇毒血凝酶注射液，能有效减少全髋关节置换术后失血量， 降低输血率，并且不增加静脉血栓形成的风险。 |
| 关键词: 蛇毒血凝酶注射液 氨甲环酸 全髋关节置换术 失血量 |
| DOI：10.3969/j.issn.1007-6948.2019.04.021 |
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| 基金项目: |
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| Topical Application of Hemocoagulase in Total Hip Arthroplasty |
| MA Sheng-shan,HUANG Cong-wei,SUN Yang,JING Cheng-zhe |
| Department of Sports Medicine, the First People’s Hospital of Lianyungang, Lianyungang (222000), China;Department of Orthopedics, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital) (Nanjing 210000) |
| Abstract: |
| Objective To investigate the effectiveness and safety of topical application of hemocoagulase in total hip arthroplasty (THA). Methods A total of 45 patients undergoing total hip arthroplasty were enrolled in this randomized controlled trial. Each group contains 15 patients. Patients in group A were not given any hemostatic agents while 50 mL tranexamic acid was injected intra-articular in group B and 12 mL hemocoagulase in group C. The sex, age, body mass index (BMI), preoperative hemoglobin (Hb), platelets, coagulation routine, intraoperative blood loss, postoperative drainage in 24 h, blood transfusions rate, and postoperative hemoglobin of patients in each group were collected. Clinical symptoms of deep venous thrombosis (DVT), pulmonary embolism (PE), pneumonia and incision infection were observed. Results There was no statistic signi?cance in intraoperative blood loss, incidence of DVT, pneumonia, incision infection and other complications in the three groups (P > 0. 05), but there was statistic signi?cance in postoperative drainage in 24 h [(396. 7± 139.5)mL vs ( 303. 3± 91. 5) mL vs ( 206. 7± 106. 7) mL, P < 0. 05], blood transfusions rate ( 33. 3% vs 13. 3% vs 0,P<0.05) and postoperative hemoglobin [(87.9±10.6) g/L vs (96.9±10.7) g/L vs (107.2±11.1) g/L, P<0.05]. No complication occured in the three groups. Conclusion Topical use of hemocoagulase following THA is effective in reducing blood loss and transfusion rate without increasing the risk of DVT and other substantial complications. |
| Key words: Hemocoagulase tranexamic acid total hip arthroplasty blood loss |
