| 谢佩耕△，尹东，梁斌，熊春翔▲.在全髋关节置换术后减少围手术期失血量及降低异位骨化风险的研究[J].中国医药科学,2025,(2):66-69 基金项目:广西壮族自治区南宁市青秀区科技计划项目（2020034）；广西自然科学基金项目（2021GXNSFBA220042） |
| 在全髋关节置换术后减少围手术期失血量及降低异位骨化风险的研究 |
| Reduction of perioperative blood loss and risk of heterotopic ossification after total hip arthroplasty |
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| DOI： |
| 中文关键词: 全髋关节置换术；氨甲环酸；异位骨化；失血量；关节腔注药 |
| 英文关键词:Total hip arthroplasty; Tranexamic acid; Heterotopic ossification; Blood loss; Intra-articular injection |
| 作者 | 单位 | | 谢佩耕△，尹东，梁斌，熊春翔▲ | 广西壮族自治区人民医院骨科，广西南宁 530021 |
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| 中文摘要: |
| [摘要] 目的 本研究采用在关节腔内注射氨甲环酸预防全髋关节置换术后异位骨化（HO）的治疗方案，旨在证实氨甲环酸关节腔注射可进一步减少围手术期失血量及降低术后髋关节周围发生HO的风险。 方法 选取2020年1月至2023年3月广西壮族自治区人民医院骨科收治的全髋关节置换术患者60例，根据随机数表法将患者分为试验组和对照组，每组各30例。两组均于术前30 min静脉使用氨甲环酸，试验组则在假体置入后关节腔内注射氨甲环酸。收集两组患者住院期间一般信息及检验结果，比较围手术期失血、引流情况，并观察两组术后12个月内骨盆及股骨X线的Brooker评分，绘制Kaplan-Meier曲线，比较两组HO发生率。 结果 试验组术后72 h失血量、引流量较对照组明显减少，差异有统计学意义（P < 0.05）；术后12个月内，试验组Ⅰ级HO发生3例，对照组Ⅰ级HO发生7例；试验组Ⅱ级HO发生1例，对照组Ⅱ级HO发生4例，两组间术后12个月内HO总发生率比较，差异有统计学意义（P < 0.05）。 结论 在全髋关节置换术中，关节腔内注射氨甲环酸可更加有效减少围手术期失血量，有助于降低HO风险。 |
| 英文摘要: |
| [Abstract] Objective To confirm that the intra-articular injection of tranexamic acid can further reduce perioperative blood loss and lower the risk of heterotopic ossification (HO) around the hip joint after surgery by proposing a treatment regimen of intra-articular injection of tranexamic acid for the prevention of HO after total hip arthroplasty. Methods A total of 60 patients undergoing total hip arthroplasty admitted to the Department of Orthopedics of the People’s Hospital of Guangxi Zhuang Autonomous Region from January 2020 to March 2023 were selected. They were divided into the test group and the control group using the randomized numerical table method, with 30 patients in each group. Tranexamic acid was administered intravenously 30 min before surgery in both groups. The test group was given tranexamic acid via intra-articular injection after the placement of prosthesis. General information and test results during hospitalization were collected from patients in both groups. The perioperative blood loss and drainage were compared. The Brooker score of pelvic and femoral X-ray examinations was observed in both groups at 12 months after surgery. Kaplan-Meier curves were plotted to compare the incidence of HO between the two groups. Results The blood loss and drainage volume within 72 hours after surgery were significantly reduced in the test group compared with the control group, with statistically significant differences (P < 0.05). At 12 months after surgery, 3 cases of gradeⅠHO occurred in the test group and 7 cases of gradeⅠHO occurred in the control group. 1 case of gradeⅡHO occurred in the test group and 4 cases of gradeⅡHO occurred in the control group. The difference in the total incidence of HO within 12 months after surgery between the two groups was statistically significant (P < 0.05). Conclusion In total hip arthroplasty, intra-articular injection of tranexamic acid may be more effective in reducing perioperative blood loss and help lower the risk of heterotopic ossification. |
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