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山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (1): 67-70.doi: 10.6040/j.issn.1671-7554.0.2015.687

• 临床医学 • 上一篇    下一篇

局部应用氨甲环酸干预股骨粗隆间骨折PFNA内固定术后隐性失血的临床分析

林锦秀,孙东升,郑潇,尹德超,李晔,王鲲鹏   

  1. 淄博市第一医院骨一科, 山东 淄博 255200
  • 收稿日期:2015-07-20 出版日期:2016-01-11 发布日期:2016-01-11
  • 通讯作者: 孙东升. E-mail:dongsheng588@sina.com E-mail:dongsheng588@sina.com

Impact of topical use of tranexamic acid on hidden blood loss after femoral intertrochanteric fracture fixation with PFNA

LIN Jinxiu, SUN Dongsheng, ZHENG Xiao, YIN Dechao, LI Ye, WANG Kunpeng   

  1. Department of Orthopedics, First Hospital of Zibo City, Zibo 255200, Shandong, China
  • Received:2015-07-20 Online:2016-01-11 Published:2016-01-11

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摘要： 目的 探讨局部应用氨甲环酸干预股骨粗隆间骨折股骨防旋髓内钉(PFNA)内固定术后隐性失血的疗效和安全性。 方法 选取股骨粗隆间骨折PFNA内固定手术患者113例随机分为治疗组(n=57例)和对照组(n=56例),治疗组近端扩髓后将氨甲环酸2 g溶于20 mL生理盐水注入股骨髓腔;对照组股骨髓腔注射生理盐水20 mL。计算两组隐性失血量、显性失血量、围手术期总失血量、输血率,记录血栓性并发症发生情况。 结果 隐性失血量治疗组(572±79)mL,对照组(703±106)mL;围手术期总失血量治疗组(770±75)mL,对照组(892±83)mL;输血率治疗组40.3%,对照组60.7%。隐性失血量、围手术期总失血量、输血率治疗组均明显低于对照组,差异有统计学意义(P<0.05)。显性失血量两组差异无统计学意义(P>0.05),血栓性并发症发生情况差异无统计学意义(P>0.05)。 结论 局部应用氨甲环酸可明显减少股骨粗隆间骨折PFNA内固定术后隐性失血量、输血率,不增加血栓性疾病的发生风险。

关键词: 股骨粗隆间骨折, 隐性失血, 骨折内固定, 氨甲环酸, 股骨近端防旋髓内钉

Abstract: Objective To evaluate the efficacy and safety of topical use of tranexamic acid(TXA)to reduce hidden blood loss after femoral intertrochanteric fracture fixation with PFNA. Methods A total of 113 femoral intertrochanteric fracture patients treated with PFNA were randomly divided into two groups, treatment group(n=57), and control group (n=56). For patients in the treatment group, 2 g TXA dissolved in 20 mL normal saline was injected into the femur medullary cavity after proximal femur reaming. For patients in the control group, 20 mL normal saline was injected. The hidden blood loss, total perioperative blood loss, visible blood loss and transfusion rate, and complications of vascular events were compared between the two groups. Results The hidden blood loss, total perioperative blood loss, and transfusion rate in the treatment group and control group were(572±79)vs(703±106)mL,(770±75)vs(892±83)mL, and 40.3% vs 60.7%. There were significant differences between the two groups(all P<0.05). There were no significant differences in visible blood loss and vascular events between the two groups(P>0.05). Conclusions Topical use of TXA can significantly reduce hidden blood loss and transfusion rate after intertrochanteric fracture internal fixation with PFNA, without increasing risks of vascular events complications.

Key words: Tranexamic acid, Femoral intertrochanteric fracture, Fracture fixation, Proximal femoral nail antirotation, Hidden blood loss

中图分类号: 

  • R683.42
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