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Updated: Jun 6, 2025

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Knee Arthrocentesis in Adults
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在接受阿皮克萨班用于血栓预防治疗的全关节关节整形术患者中,应考虑使用外科手术期间的特兰克萨姆酸
Sagar Telang1, Ryan Palmer1, Andrew Dobitsch1
1Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Arthroplasty today
|November 25, 2024
概括
在接受阿皮克萨班治疗的全关节整形术 (TJA) 患者中,经外科手术后给药的松酸 (TXA) 显著降低了出血并发症. 这种方法可以降低出血和输血的风险,而不会增加血栓栓塞事件,支持其在TJA的使用.
科学领域:
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 整体关节整形术 (TJA) 患者经常接受抗凝剂,如阿皮克萨班用于血栓预防.
- 手术后出血仍然是TJA的一个问题,需要采取策略来减轻这种风险.
- 在TJA中联合使用胺酸 (TXA) 和阿皮克萨班需要对安全性和疗效进行调查.
研究的目的:
- 评估外科手术期间的特兰胺酸 (TXA) 在治疗阿皮克萨班的全关节整形术 (TJA) 患者中减少术后出血的疗效.
- 为了评估TXA的使用是否会增加TJA患者治疗阿皮克萨班的血栓栓塞事件的风险.
- 为接受阿皮克萨班治疗的TJA患者的术后管理提供基于证据的建议.
主要方法:
- 通过对Premier Healthcare数据库的回顾性分析,确定了初级选择性全膝关节整形术 (TKA) 和全关节整形术 (THA) 患者.
- 接受阿皮克萨班与术前TXA治疗的患者与仅接受阿皮克萨班治疗的患者进行了比较.
- 用多变量回归分析来比较两个组之间的90天术后出血和血栓栓塞结局.
主要成果:
- 该研究包括118,219名TJA患者; 74.1%接受了阿皮克萨班与TXA.
- 接受阿皮克萨班和TXA治疗的患者显著降低了出血并发症 (aOR 0.83),输血 (aOR 0.47) 和急性贫血 (aOR 0.84) 的风险.
- 观察到深静脉血栓 (aOR 0.74) 和肺栓塞 (aOR 0.84) 的风险降低,中风或心肌梗塞风险没有增加.
结论:
- 在治疗阿皮克萨班的TJA患者中,术后TXA的使用是安全和有效的,可以减少TJA患者的出血并发症.
- 在这种患者群体中,TXA的使用不会增加血栓栓塞事件的风险.
- 关节整形外科医生应该考虑将TXA纳入接受apixaban的TJA患者的外科护理.
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