氨甲环酸不同给药时间对初次单侧全髋关节置换术中及术后失血量的影响

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Abstract Objective To investigate the effect of different administration times of Tranexamic Acid on blood loss during and after the initial unilateral total hip arthroplasty.Methods A retrospective analysis was performed on the clinical data of 75 patients who underwent primary unilateral total hip replacement in the Second Department of Orthopedics,Nankang District Traditional Chinese Medicine Hospital from December 2018 to February 2021.According to the time of medication,they were divided into control group,preoperative group and intraoperative group with 25 cases each.All three groups were treated with routine infection prevention,anticoagulation and fluid rehydration after operation.The control group was not given hemostatic drugs.The preoperative group was given 1 g Tranexamic Acid intravenously 10 min before surgery,and 1 g intravenous drip again 6 h after surgery.The intraoperative group was given 1 g Tranexamic Acid intravenous infusion 10 min before the end of surgery,and another 1 g tranexamic acid intravenous infusion 6 h after surgery.Intraoperative blood loss,postoperative drainage,recessive blood loss,total blood loss and the number of cases of blood transfusion,hemoglobin levels 24 h before surgery,12 h,24 h and 36 h after surgery were compared among the three groups.Seven days after the operation,the blood vessels of the affected limb were reexamined by color doppler ultrasonography.Results The intraoperative blood loss,postoperative drainage,hidden blood loss and total blood loss in the preoperative and intraoperative groups were lower than those in the control group,the differences were statistically significant(P＜0.05),and the preoperative group had less intraoperative blood loss and postoperative drainage than the intraoperative group,the differences were statistically significant(P＜0.05).24 h before operation,there was no significant difference in hemoglobin level among the three groups(P ＞0.05).The hemoglobin of preoperative group and intraoperative group was higher than that of control group 12,24,36 h after operation,and the differences were statistically significant(P＜0.05).One patient in the preoperative group and one patient in the intraoperative group received blood transfusion,and the rate of blood transfusion was 4.00%(1/25),lower than that of the control group(24.00%,6/25),the differences were statistically significant(P＜0.05).No lower limb venous thrombosis occurred in the three groups.Conclusion Preoperative and intraoperative application of Tranexamic Acid can reduce blood loss after initial unilateral total hip replacement,reduce blood transfusion rate,and do not increase the risk of thrombosis,and the effect of preoperative administration is slightly better than that of intraoperative administration.medicine.

Key words： Unilateral total hip replacement Tranexamic Acid Administration at different times Blood loss Clinical research

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	LIAO Zhang-yu
	LIU Hong-yan
	ZENG Xian-hui

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LIAO Zhang-yu,LIU Hong-yan,ZENG Xian-hui. Effect of different administration times of Tranexamic Acid on blood loss during and after the initial unilateral total hip arthroplasty[J]. 中国当代医药, 2021, 28(26): 108-111.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I26/108

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