首页|口服与静脉注射氨甲环酸在原发性全髋关节和膝关节置换术中的有效性和安全性分析

口服与静脉注射氨甲环酸在原发性全髋关节和膝关节置换术中的有效性和安全性分析

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目的:探究氨甲环酸采用口服和静脉注射的给药方式在原发性全髋关节和膝关节置换术中的有效性和安全性.方法:选取我院 2022 年 11 月至 2023 年 11 月收治的 136 例原发性全髋关节和膝关节置换术患者,随机分为对照组、研究组,各 68 例,对照组给予静脉注射氨甲环酸 1.0 g治疗,研究组给予口服氨甲环酸 2.0 g治疗.观察记录两组治疗前、治疗后 3 d出血量及治疗前、治疗后 3 d应用全自动凝血分析仪、酶联免疫吸附法测定凝血功能、炎症因子及血管内皮功能指标水平,分析临床效果.结果:治疗后,相比对照组,研究组出血量、凝血原酶时间(Prothrombin time,PT)、活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)水平、可溶性血栓调节蛋白(Soluble thrombmodulin,sTM)、E-选择素、血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平略低(P>0.05);纤维蛋白原(Fibrinogen,FIB)水平、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(Interleukin-6,IL-6)水平及治疗总有效率略高(P>0.05).研究组并发症发生率低于对照组,差异有统计学意义(P<0.05).结论:口服与静脉注射氨甲环酸用于原发性全髋关节和膝关节置换术中均有显著治疗效果,但口服氨甲环酸安全性更高,值得推广.
Effects and safety of oral and intravenous tranexamic acid in primary total hip and knee arthroplasty
Objective:To explore the efficacy and safety of oral and intravenous administration of tranexamic acid in primary total hip and knee replacement.Methods:A total of 136 patients with primary total hip and knee arthroplasty admitted to our hospital from November 2022 to November 2023 were randomly divided into the control group and the study group,with 68 cases in each group.The control group was given 1.0 g intravenous tranexamic acid treatment,and the study group was given 2.0 g oral tranexamic acid treatment.Blood loss before and 3 days after treatment was observed and recorded in the two groups,and the levels of coagulation function,inflammatory factors,and vascular endothelial function indexes were measured by automatic coagulation analyzer and enzyme-linked immunosorbent assay before and 3 days after treatment,and the clinical effects were analyzed.Results:After treatment,compared with the control group,the study group had slightly lower levels of bleeding volume,prothrombin time(PT),activated partial thromboplastin time(APTT),soluble thrombomodulin(sTM),E-selectin,and vascular endothelial growth factor(VEGF)(P>0.05).Fibrinogen(FIB)levels,C-reactive protein(CRP),interleukin-6(IL-6)levels,and overall treatment efficacy were slightly higher(P>0.05).The incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion:Both oral and intravenous tranexamic acid have significant therapeutic effects in primary total hip and knee replacement,but oral tranexamic acid is safer and worthy of promotion.

Oral administrationIntravenous injectionAminomethylcyclopentanoic acidPrimary total hip jointKnee joint replacement surgery

刘文坤、赵颖、王允江、邢林卿

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商丘市第三人民医院骨科,河南 商丘 476000

口服 静脉注射 氨甲环酸 原发性全髋关节 膝关节置换术

河南省医学科技攻关计划联合共建项目

LHGJ20200677

2024

四川生理科学杂志
四川省生理科学会

四川生理科学杂志

影响因子:0.575
ISSN:1671-3885
年,卷(期):2024.46(9)
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