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基于体重的特兰胺酸在减少手术后的血液损失方面比修复关节整形术中的固定剂量疗法更有效:一项比较研究

Chenchen Yang¹, Baochao Ji¹, Guoqing Li¹

¹Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Key Laboratory of High Incidence Disease Research in Xingjiang (Xinjiang Medical University), Ministry of Education, Urumqi, Xinjiang, 830054, China; Xinjiang Clinical Research Center for Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

The Journal of arthroplasty

|July 30, 2025

概括

与固定剂量TXA相比,基于体重的tranexamic acid (TXA) 在修复全关节整形术 (rTHA) 中显著降低了血液损失. 这种优化剂量策略没有增加死亡率或并发症,提供了更安全的血液管理方法.

科学领域:

整形外科手术整形外科手术
麻醉学麻醉学
药理学药理学是指药理学的学科.

背景情况:

对于手术性失血的最佳静脉注射松酸 (TXA) 剂量仍在争论中.
修复性全关节整形手术 (rTHA) 在管理外科手术期间的血液损失方面存在挑战.

研究的目的:

为了比较固定剂量与基于体重的TXA疗法,以控制rTHA中的血液损失.
评估不同TXA剂量策略对输血率,死亡率和并发症的影响.

主要方法:

对377名接受rTHA.治疗的患者进行了回顾性比较分析.
组:没有TXA,固定剂量TXA (1g IV + 1g局部),和基于体重的TXA (20 mg/kg/h IV + 1g局部).
测量结果:血红蛋白降低,输血率,死亡率和并发症.

主要成果:

基于体重的TXA显示血红蛋白降低明显低于没有TXA和固定剂量TXA (分别为27.8和41.9g/L和39.0g/L).
两组TXA的输血率都低于无TXA组;固定剂量TXA的输血率低于基于体重的TXA.
两组之间没有观察到死亡率或重大并发症的显著差异.

结论:

与固定剂量TXA相比,基于体重的TXA有效地减少了手术后的rTHA输血.
这种剂量策略不会增加住院死亡或重大并发症的风险.
推实施基于体重的TXA,以优化在rTHA中的血液损失管理.

关键词:

输血输血输血输血输血这是一个复杂的并发症.修订整体关节整形术特兰克萨姆酸是什么意思输血是输血的方法之一.

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