氨甲环酸多次静脉给药在胫骨高位截骨术中的安全性与抗炎作用

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Abstract Objective To investigate the safety and anti-inflammatory effects of tranexamic acid(TXA)on high tibial osteotomy(HTO).Methods 224 patients who met the criteria for high tibial osteotomy were included in the study using a randomized controlled clinical method.112 cases were included in group A including 58 males and 54 females.The average age was (49.33±6.83)years.TXA was administered 10 to 15 minutes before dermectomy，and another 1 g was intravenously 3 h，6 h and 9 h after surgery.Group B had 112 cases，including 49 males and 63 females.The average age was (52.21±6.28)years.15 mg/kg TXA was given 10~15 min before dermectomy，and another 1 g was given intravenously 3 h later.according to the TXA study plan.All patients were followed up for 9 months.Total blood loss，postoperative recessive blood loss，postoperative drainage volume at 24 hours，operative time，anti-inflammatory factors including C-reactive protein(CRP)、interleukin 6(IL-6) and erythrocyte sedimentation rate(ESR) 3 days after surgery.Incidence of venous thrombosis，wound complications，and other complications were recorded and compared between the two groups.Results All patients were followed up for 9 months.The total postoperative blood loss，the recessive blood loss and the 24 h postoperative drainage volume of patients in the A group were significantly lower than those in the B group，and the differences were significant (P＜0.05).CRP，IL-6and ESR were all lower in group A than in group B at 1，3 and 5 days after surgery，and the differences were statistically significant (P＜0.05).The peri-menstrual value of the affected limb and the incidence of ecchymosis hematoma in group A 1，3 and 5 days after surgery were all lower than those in group B，and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of deep vein thrombosis between the two groups at 1 day，2 weeks and 4 weeks after surgery(P＞0.05).There was no significant difference in WOMAC score and operation time between the two groups before surgery，1 month and 3 months after surgery(P＞0.05).There was no respiratory infection or pulmonary embolism in the two groups，and there was 1 case of urinary infection in group B，two weeks after the operation.Conclusion Repeated administration of TXA reduced perioperative blood loss in patients undergoing HTO without increasing the incidence of venous thrombosis，and showed significant antiinflammatory effects with the increase of administration times.

Key words： tranexamic acid tibia osteotomy venous thromboembolism anti-inflammatory factor complication

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