氨甲环酸控制肩关节镜术后关节腔出血的临床研究
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作者Author单位AddressE-Mail
高华利 gaohuali 上海中医药大学附属光华医院 Guanghua hospital affiliated to Shanghai university of traditional Chinese medicine flyggg@163.com 
张杰超 zhang Jie-chao 上海中医药大学附属光华医院关节矫形外科  
何勇* He Yong 上海中医药大学附属光华医院 Guanghua hospital affiliated to Shanghai university of traditional Chinese medicine hernshall@qq.com 
翟伟韬 Zhai Wei-tao 上海中医药大学附属光华医院关节矫形外科  
肖涟波 Xiao Lian-bo 上海中医药大学附属光华医院关节矫形外科  
施杞 Shi Qi 上海中医药大学  
期刊信息:《中国骨伤》年,第卷,第期,第-页
DOI:
基金项目:上海市科学技术委员会中医引导项目(编号:17401933000)
中文摘要:目的:通过临床研究探讨氨甲环酸控制肩关节镜术后关节腔出血的临床疗效。方法:自2018年2月至2018年7月,肩关节镜下治疗肩袖撕裂患者60例,按随机数字表法分为观察组和对照组,每组30例。观察组男6例,女24例,年龄55~70岁,平均(62.3±5.5)岁,病程2~36(11.7±1.7)个月;对照组男5例,女25例,年龄56~72岁,平均(63.4±5.8)岁,病程4~36(10.8±1.4) 个月;观察组术后关节腔及肩峰下各注射0.5g氨甲环酸(1g氨甲环酸生理盐水稀释至20ml),对照组关节腔及肩峰下各注射生理盐水10ml,记录术前及术后1天两组血红蛋白值、测量术前及术后1、7天肩关节周径并计算肩关节周径差值,记录皮下瘀血瘀斑及深静脉血栓等并发症。结果:术前及术后第1天观察组血红蛋白值与对照组血红蛋白值差异没有统计学意义(P>0.05);术后第1天观察组肩关节周径(32.9±0.3)cm明显小于对照组(35.1±0.5)cm,肩关节周径差值(8.7±0.4)mm也明显低于对照组(12.3±0.5)mm,差异有统计学意义(P<0.05),但术后第7天,两组肩关节周径及肩关节周径差值差异均不明显(P>0.05);观察组皮下瘀斑发生例数(2例)少于对照组(6例),但两组比较统计学差异不明显(P>0.05);两组患者均未发生深静脉血栓。结论:肩峰下及关节腔注射氨甲环酸能明显减轻肩关节镜术后早期软组织肿胀,具有较好安全性。
【关键词】氨甲环酸  肩关节镜手术  关节腔出血
 
Clinical study on tranexamic acid control of articular cavity bleeding after shoulder arthroscopy
ABSTRACT  Objective: Clinical study was conducted to investigate the efficacy of tranexamic acid in the control of intraarticular hemorrhage after shoulder arthroscopy. Method: From February 2018 to July 2018, 60 cases of rotator cuff tears treated by shoulder arthroscopy were randomly divided into observation group and control group, 30 cases in each group. In the observation group, there are 6 males and 24 females,55~70 years old, with an average age of(62.3±5.5)years and a course of disease of 2~36(11.7±1.7)months. In the control group, there were 5 males and 25 females,56~72 years old, with an average age of (63.4±5.8) years and a course of 4~36(10.8±1.4)months. The observation group received 0.5g of tranexamic acid (1g of tranexamic acid was diluted with normal saline to 20ml) in each articular cavity and Subacromial space after surgery. In the control group, 10ml of normal saline was injected into the joint cavity and Subacromial space respectively.The hemoglobin values of the two groups before and one day after operation were recorded. The circumference of shoulder joint was measured preoperatively and the 1st and 7th days after surgery. The circumference difference of shoulder joint was recorded. Complications such as subcutaneous blood stasis and DVT were recorded. Results: There was no statistically significant difference in hemoglobin values between the observation group and the control group before and the first day after surgery(P>0.05). On the first day after surgery, the peripheral diameter of the shoulder in the observation group (32.9±0.3)cm was significantly lower than that in the control group (35.1±0.5)cm, and the circumference difference of the shoulder (8.7±0.4)mm was also significantly lower than that in the control group (12.3±0.5)mm, the difference was statistically significant (P < 0.05).However, on the seventh day after surgery, there was no significant difference in the circumference of shoulder joint and the difference in the circumference of shoulder joint between the two groups(P>0.05). The number of cases of subcutaneous ecchymosis in the observation group (2 cases) was less than that in the control group (6 cases), but the difference between the two groups was not statistically significant(P>0.05).Conclusion: Subacromial and articular injection of tranexamic acid can significantly reduce the early soft tissue swelling after arthroscopic shoulder surgery, with good safety.
KEY WORDS  Tranexamic acid  Shoulder arthroscopic surgery  Joint cavity bleeding
 
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