[1]冯 敏,袁春明,强 辉,等.局部联合静脉应用氨甲环酸对股骨近端防旋髓内钉治疗老年股骨粗隆间骨折患者围手术期失血量及并发症的影响[J].陕西医学杂志,2023,52(9):1214-1217.[doi:DOI:10.3969/j.issn.1000-7377.2023.09.023]
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局部联合静脉应用氨甲环酸对股骨近端防旋髓内钉治疗老年股骨粗隆间骨折患者围手术期失血量及并发症的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年9期
页码:
1214-1217
栏目:
临床研究
出版日期:
2023-09-05

文章信息/Info

作者:
冯 敏1; 袁春明1; 强 辉1; 赵金国2
(1.陕西省人民医院骨科,陕西 西安 710068; 2.宜君县人民医院外科,陕西 宜君 727200)
关键词:
股骨粗隆间骨折;  氨甲环酸;  老年;  股骨近端防旋髓内钉;  出血量;  并发症
分类号:
R 683.42
DOI:
DOI:10.3969/j.issn.1000-7377.2023.09.023
文献标志码:
A
摘要:
目的:探讨局部联合静脉应用氨甲环酸(TXA)对股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折患者围手术期失血量及并发症的影响。方法:选取使用PFNA治疗股骨粗隆间骨折的患者100例为研究对象。所有患者被分成TXA组和对照组(NS组),每组50例。TXA组分别于术前30 min静脉注射TXA 1 g/100 ml,同时于创面闭合前用2 g/100 ml TXA溶液浸泡创面5 min。NS组术前静脉滴注0.9%氯化钠注射液100 ml。分别于手术当天和术后第5天进行血常规检查,计算两组总出血量和隐性出血量。比较两组术中出血量、隐性出血量、引流量、输血量、总出血量及并发症。所有患者均于术前及术后1周进行下肢深静脉超声检查,记录下肢深静脉血栓形成的发生情况。结果:与NS组比较,TXA组显性出血量、隐性出血量、输血量、输血率及总出血量低于NS组(均P<0.05)。无论是NS组还是TXA组,与接受长钉固定的患者比较,接受短钉固定的患者术中出血量比较无统计学差异(P>0.05),但是隐性出血量和总出血量明显减少(均P<0.05)。两组下肢深静脉血栓形成、伤口血肿、伤口感染、脑血管意外及出院后1个月再入院等方面比较无统计学差异(均P>0.05)。结论:局部联合静脉应用氨甲环酸可以显著减少老年股骨粗隆间骨折患者使用PFNA治疗时的出血量,使用短钉固定的隐性出血量较使用长钉固定明显减少,同时这种用药方式并没有增加下肢深静脉血栓形成等并发症的发生风险。

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备注/Memo

备注/Memo:
基金项目:陕西省科技计划项目(2021SF-251); 陕西省人民医院人才支持计划项目(2021BJ-24)
更新日期/Last Update: 2023-09-04