J Arthroplasty:全髋关节置换术,局部 VS.静脉注射氨甲环酸

2016-07-06 MedSci MedSci原创

已知氨甲环酸可减少全髋关节置换术围手术期失血。采用随机对照试验研究设计,共纳入了139名患者,分别接受2 g氨甲环酸局部应用或静脉注射。标准化术前和术后的方案。结果,与局部应用组患者相比 (160.3 [g] ± 63.8, 188.4 [g] ± 68.5; P = .014),静脉注射组患者血液和血红蛋白的损失量较低(1195.0 ± 485.9 mL, 1442.7 ± 562.7 mL;

已知氨甲环酸可减少全髋关节置换术围手术期失血。

采用随机对照试验研究设计,共纳入了139名患者,分别接受2g氨甲环酸局部应用或静脉注射。标准化术前和术后的方案。

结果,与局部应用组患者相比 (160.3 [g] ± 63.8, 188.4 [g] ± 68.5; P = .014),静脉注射组患者血液和血红蛋白的损失量较低(1195.0 ± 485.9 mL, 1442.7 ± 562.7 mL; P = .006)。在减少输血上存在一个有意义的趋势(11% [静脉注射]VS.18% [局部应用];P =。3)。无论是局部应用还是静脉注射均可有效地降低输血率。使用氨甲环酸可有效节约医疗费用,每名全髋关节置换术可节约314美元。

总而言之,氨甲环酸局部应用还是静脉注射都可有效减少全髋关节置换术的失血量,降低输血的费用,但是为了方便应用,更建议使用静脉注射的方式。

原始出处:

North WT, et al. Topical vs Intravenous Tranexamic Acid in Primary Total Hip Arthroplasty: A Double-Blind, Randomized Controlled Trial. J Arthroplasty. 2016;doi:10.1016/j.arth.2015.11.003.


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  1. 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    2017-04-17 fusion
  3. 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    2016-08-21 yxch48
  4. 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createdBy=0bc129907796, createdName=fusion, createdTime=Mon Apr 17 16:41:00 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742367, encodeId=17251e4236740, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Sun Aug 21 00:41:00 CST 2016, time=2016-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754160, encodeId=64261e5416092, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, 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GetPortalCommentsPageByObjectIdResponse(id=129403, encodeId=de9412940309, content=不错哦,会学到很多,喜欢梅斯医学文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Sep 17 11:43:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=107375, encodeId=b07d10e375ca, content=好文,值得学习,赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Aug 30 11:15:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356081, encodeId=f35913560817e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405693, encodeId=674614056933f, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492454, encodeId=08b2149245416, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=)]
  5. 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encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492454, encodeId=08b2149245416, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1710881, encodeId=b4a71e108812f, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Fri Apr 14 20:41:00 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697329, encodeId=5ed4169e329a2, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Mon Apr 17 16:41:00 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742367, encodeId=17251e4236740, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Sun Aug 21 00:41:00 CST 2016, time=2016-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754160, encodeId=64261e5416092, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30135, encryptionId=7d3330135ac, topicName=关节置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=050736663344, createdName=apoenzyme, createdTime=Mon Dec 12 22:41:00 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021996, encodeId=0fb220219966a, content=<a href='/topic/show?id=3d3929e567d' target=_blank style='color:#2F92EE;'>#全髋关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29756, encryptionId=3d3929e567d, topicName=全髋关节)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKUdkK5dVTue7YQDvwqM1ugOuEpDZEzvXhoGClFiavehcrNAYDuPbks3MkKLPpyAEicgic80KguxwicYQ/132, createdBy=ec952500165, createdName=ms5187542471278033, createdTime=Mon Sep 19 13:41:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), 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createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Aug 30 11:15:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356081, encodeId=f35913560817e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405693, encodeId=674614056933f, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492454, encodeId=08b2149245416, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=)]
    2016-09-17 1e10c84am36(暂无匿称)

    不错哦,会学到很多,喜欢梅斯医学文章

    0

  7. 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createdBy=0bc129907796, createdName=fusion, createdTime=Mon Apr 17 16:41:00 CST 2017, time=2017-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742367, encodeId=17251e4236740, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Sun Aug 21 00:41:00 CST 2016, time=2016-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1754160, encodeId=64261e5416092, content=<a href='/topic/show?id=7d3330135ac' target=_blank style='color:#2F92EE;'>#关节置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30135, encryptionId=7d3330135ac, topicName=关节置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=050736663344, createdName=apoenzyme, createdTime=Mon Dec 12 22:41:00 CST 2016, time=2016-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021996, encodeId=0fb220219966a, content=<a href='/topic/show?id=3d3929e567d' target=_blank style='color:#2F92EE;'>#全髋关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29756, encryptionId=3d3929e567d, topicName=全髋关节)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKUdkK5dVTue7YQDvwqM1ugOuEpDZEzvXhoGClFiavehcrNAYDuPbks3MkKLPpyAEicgic80KguxwicYQ/132, createdBy=ec952500165, createdName=ms5187542471278033, createdTime=Mon Sep 19 13:41:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129403, encodeId=de9412940309, content=不错哦,会学到很多,喜欢梅斯医学文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Sep 17 11:43:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=107375, encodeId=b07d10e375ca, content=好文,值得学习,赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Aug 30 11:15:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356081, encodeId=f35913560817e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405693, encodeId=674614056933f, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492454, encodeId=08b2149245416, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=)]
    2016-08-30 ylzr123

    好文,值得学习,赞!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1710881, encodeId=b4a71e108812f, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Fri Apr 14 20:41:00 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697329, encodeId=5ed4169e329a2, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492454, encodeId=08b2149245416, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=)]
    2016-07-08 zhaojie88
  9. 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encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492454, encodeId=08b2149245416, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Fri Jul 08 08:41:00 CST 2016, time=2016-07-08, status=1, ipAttribution=)]
    2016-07-08 chg122
  10. 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