老年股骨转子间骨折治疗过程中氨甲环酸的应用.

BACKGROUND: Studies have shown that tranexamic acid can reduce blood loss in patients with total hip and total knee replacement, reduce blood transfusion rate, and does not affect coagulation function, and does not increase the risk of lower extremity deep vein thrombosis. However, there are few studies on the application of tranexamic acid in elderly intertrochanteric fracture surgery, and there is still a lack of reliable clinical data to support it. OBJECTIVE: To investigate the efficacy and safety of tranexamic acid in trochanteric fixation nail-advanced for femoral intertrochanteric fracture in the elderly. METHODS: A total of 50 patients who met the inclusion criteria and were included in Chongqing Ninth People’s Hospital from January 2021 to April 2022 were enrolled in this study. The subjects were divided into two groups according to the random number table method. In the experimental group, 1 g of tranexamic acid was added into 100 mL normal saline and drip intravenously 15 minutes before operation. In the control group, 100 mL normal saline was drip intravenously 15 minutes before operation. The operation time, intraoperative blood loss, postoperative drainage, blood transfusion, hemoglobin, hematocrit, fibrin (before and on the third day after operation), and thrombosis (at 3 days, 1, 3 and 6 weeks after operation) were recorded in both groups. RESULTS AND CONCLUSION: (1) There was no significant difference in operation time, preoperative hemoglobin, hematocrit, preoperative and postoperative fibrin between the two groups (P > 0.05). The postoperative hemoglobin and hematocrit in the control group were significantly lower than those in the experimental group (P < 0.05). (2) The intraoperative blood loss, postoperative drainage volume, hidden blood loss and total blood loss in the experimental group were less than those in the control group (P < 0.05). (3) There was no significant difference in thrombotic events between the two groups (P > 0.05). The blood transfusion events in the experimental group were significantly lower than those in the control group (P < 0.05). (4) In the elderly patients with femoral intertrochanteric fracture undergoing trochanteric fixation nail-advanced surgery, the application of tranexamic acid can reduce the intraoperative blood loss, postoperative drainage volume and hidden blood loss, reduce the total perioperative blood loss, reduce the blood transfusion rate, and increase the postoperative hemoglobin and hematocrit, without increasing the risk of thromboembolic events and the impact on fibrin. [ABSTRACT FROM AUTHOR]