初次全髋关节置换术中静脉注射与关节内注射氨甲环酸:一项前瞻性随机双盲非效性试验

A. Hasan, D. Campbell, P. Lewis
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引用次数: 1

摘要

背景:氨甲环酸(TXA)已被证明能有效减少髋关节置换术后的术后失血。临床医生可能不愿意给高危患者静脉注射(IV)TXA,关节内注射(IA)已被提议作为一种替代分娩方式。本研究旨在比较静脉注射与IA给药TXA的疗效。这项前瞻性、双盲、随机非劣效性试验比较了69名接受原发性全髋关节置换术(THA)的患者,这些患者在包膜闭合后接受了3剂15mg/kg静脉注射TXA或3 g IA TXA。主要结果是Hb和输血率的变化。次要结果是VTE的发生率。结果:静脉注射组术前至术后第1天的平均血红蛋白水平变化为26.7g/L,IA组为27.3g/L。两组之间没有统计学显著差异(p=0.82)。没有患者需要输血或发生VTE。结论:TXA的IA给药与IV给药在减少原发性THA患者的失血和预防术后贫血方面同样有效。背景
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intravenous versus Intra-Articular Tranexamic Acid in Primary Total Hip Arthroplasty: A Prospective Randomised Double Blinded Non-Inferiority Trial
Background: Tranexamic acid (TXA) has been shown to be effective in reducing post-operative blood loss after hip replacement surgery. Clinicians can be reluctant to administer intravenous (IV) TXA to high risk patients and intra-articular (IA) administration has been proposed as an alternative mode of delivery. This study was conducted to compare the efficacy of IV versus IA administration of TXA. This prospective, double blinded, randomised non-inferiority trial, compared 69 patients undergoing primary total hip arthroplasty (THA) who received either 3 doses of 15mg/kg of IV TXA or 3 g of IA TXA after capsular closure. The primary outcomes were change in Hb and the rate of blood transfusion. The secondary outcome was the rate of VTE. Results: The mean haemoglobin level change from pre-operative to day 1 post-operative for the IV group was 26.7g/L and for IA group was 27.3g/L. No statistically significant difference was detected between the two groups (p=0.82). No patients required a transfusion or developed a VTE. Conclusions: IA administration of TXA can be equally effective as IV in the reduction of blood loss and the prevention of post-operative anaemia in primary THA. Background
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