在手术期间给予特兰克萨姆酸和低分子量肝素,以改善关骨折中的血液管理:一项随机对照研究
Chunyong Zhu1, Zhongqing Ji1, Jiangfeng Zhu1
1Department of Orthopedic Surgery, Suzhou Yongding Hospital, Suzhou, Jiangsu, China (mainland).
概括
一种新型的4剂量松酸 (TXA) 疗法显著减少了手术前的血液流失,这是在进行内钉的内骨折患者身上. 这种改善的血液管理并没有增加深静脉血栓塞 (DVT) 风险.
科学领域:
- 整形外科手术 整形外科手术
- 创伤管理 创伤管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 胸腔间骨折 (IF) 与显著的外科手术期间失血 (PBL) 有关.
- 内钉 (IMN) 是IF的常见手术治疗方法.
- 在IF手术期间优化血液静止对于患者的治疗结果至关重要.
研究的目的:
- 为了比较三种结合的酸 (TXA) 和低分子量肝素 (LMWH) 治疗方案在IMN治疗的IF患者中减少PBL的疗效.
- 为了评估一个新的4剂量TXA治疗方案,用于外科手术期间的静血控制.
主要方法:
- 一项前性单中心研究,涉及79名接受IMN治疗的IF患者.
- 患者被随机分配到三个组:4剂量TXA,1剂量TXA和对照组.
- 在不同的手术前时间内静脉注射TXA,手术后12小时开始LMWH.
主要成果:
- 与1剂TXA和对照组 (P<0.05) 相比,四剂TXA组的隐性血液损失 (HBL) 和总血液损失 (TBL) 显著降低 (P<0.05).
- 4剂量TXA组 (640.86±337.22毫升) 的TBL最低,其次是1剂量TXA组 (971.74±511.14毫升) 和对照组 (1226.27±458.22毫升).
- 深静脉血栓症 (DVT) 的发生率在三组中没有显著差异.
结论:
- 4剂量TXA疗法,与LMWH结合,有效地降低了手术前血液流失,在IMN治疗的胸腔间骨折患者.
- 这种优化的TXA协议似乎不会增加深静脉血栓形成的风险.
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