Reduction of blood loss in primary hip arthroplasty with tranexamic acid or fibrin spray.
Reduction of blood loss in primary hip arthroplasty with tranexamic acid or fibrin spray.
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DOI：
10.3109/17453674.2011.623568
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发表时间：
2011-12
影响因子：
3.7
通讯作者：
Kinninmonth AW
中科院分区：
文献类型：
--
作者：
McConnell JS;Shewale S;Munro NA;Shah K;Deakin AH;Kinninmonth AW
以前的研究表明，纤维蛋白喷雾剂或氨甲环酸可以减少全髋关节置换术中的失血量，但这两种治疗方法没有直接比较。因此，我们进行了一项随机对照试验。 在这项随机对照试验中，我们比较了氨甲环酸和纤维蛋白喷雾剂对骨水泥型全髋关节置换术中失血量的影响。将66例患者随机分配至3个平行组中的1个，接受（1）术前10 mg/kg氨甲环酸推注，（2）术中10 mL纤维蛋白喷雾剂，或（3）均不接受。除外科医生外，所有参与者均对治疗组设盲，直至数据分析完成。根据术前和术后红细胞压积计算失血量。 在总体失血量方面，两种活性治疗均不上级另一种。当使用氨甲环酸（降低22%，p = 0.02）或纤维蛋白喷雾剂（降低32%，p = 0.02）时，损失低于对照组。 我们发现，与对照组相比，在诱导时使用氨甲环酸或术中局部纤维蛋白喷雾剂可减少失血量。纤维蛋白喷雾组和氨甲环酸组的失血量相似。ClinicalTrials.gov标识符：NCT 00378872 EudraCT标识符：2006-001299-19地区伦理委员会批准：06/S 0703/55，2006年6月6日授予
Previous studies have shown that either fibrin spray or tranexamic acid can reduce blood loss at total hip replacement, but the 2 treatments have not been directly compared. We therefore conducted a randomized, controlled trial. In this randomized controlled trial we compared the effect of tranexamic acid and fibrin spray on blood loss in cemented total hip arthroplasty. 66 patients were randomized to 1 of 3 parallel groups receiving (1) a 10 mg/kg bolus of tranexamic acid prior to surgery, (2) 10 mL of fibrin spray during surgery, or (3) neither. All participants except the surgeon were blinded as to treatment group until data analysis was complete. Blood loss was calculated from preoperative and postoperative hematocrit. Neither active treatment was found to be superior to the other in terms of overall blood loss. Losses were lower than those in the control group, when using either tranexamic acid (22% lower, p = 0.02) or fibrin spray (32% lower, p = 0.02). We found that the use of tranexamic acid at induction, or topical fibrin spray intraoperatively, reduced blood loss compared to the control group. Blood loss was similar in the fibrin spray group and in the tranexamic acid group. ClinicalTrials.gov identifier: NCT00378872 EudraCT identifier: 2006-001299-19 Regional Ethics Committee approval: 06/S0703/55, granted June 6, 2006