全髋关节置换术后药物对隐性失血的影响
Effect of Drugs on Hidden Blood Loss after Total Hip Arthroplasty
DOI: 10.12677/ACM.2021.112080, PDF,   
作者: 姬 祥*, 魏开斌#, 张 建, 杨楠楠:山东第一医科大学(山东省医学科学院)研究生院,山东 泰安
关键词: 全髋关节置换术围手术期隐性失血药物Total Hip Arthroplasty Perioperitive Period Hidden Blood Loss Drugs
摘要: 全髋关节置换术(total hip arthroplasty, THA)广泛应用于髋关节退行性变、股骨头坏死、髋关节发育不良等髋关节终末期疾病,取得了很好的疗效。但在围术期失血较多,尤其隐性失血(hidden blood loss, HBL)占比较高,影响了治疗效果。临床上减少围术期隐性失血的方法很多,本文主要从氨甲环酸、抗凝药及中药等方面来阐述药物对隐性失血的影响。
Abstract: Total hip arthroplasty (THA) is a widely used method to treat hip degenerative diseases, femoral head necrosis, hip dysplasia and other end-stage hip diseases. However, there is a lot of blood loss during the perioperative period, hidden blood loss (HBL) accounts for a relatively high amount, it affects the therapeutic effect. There are many clinical methods to reduce perioperative recessive blood loss. This article mainly discusses the effect of drugs on hidden blood loss from the aspects of tranexamic acid, anticoagulant and Chinese medicine.
文章引用:姬祥, 魏开斌, 张建, 杨楠楠. 全髋关节置换术后药物对隐性失血的影响[J]. 临床医学进展, 2021, 11(2): 553-558. https://doi.org/10.12677/ACM.2021.112080

参考文献

[1] Claeys, M.A., Vermeersch, N. and Haentjens, P. (2007) Reduction of Blood Loss with Tranexamic Acid in Primary Total Hip Replacement Surgery. Acta Chirurgica Belgica, 107, 397-401. [Google Scholar] [CrossRef] [PubMed]
[2] Rajesparan, K., Biant, L.C., Ahmad, M., et al. (2009) The Effect of an Intravenous Bolus of Tranexamic Acid on Blood Loss in Total Hip Replacement. Journal of Bone and Joint Surgery, 91, 776-783. [Google Scholar] [CrossRef
[3] Liu, X., Zhang, X., Chen, Y., et al. (2011) Hidden Blood Loss after Total Hip Arthroplasty. The Journal of Arthroplasty, 26, 1100-1105. [Google Scholar] [CrossRef] [PubMed]
[4] Wu, Y.S., Zhang, H., Zheng, W.H., et al. (2017) Hidden Blood Loss and the Influential Factors after Percutaneous Kyphoplasty Surgery. European Spine Journal, 26, 1878-1883. [Google Scholar] [CrossRef] [PubMed]
[5] Sehat, K.R., Evans, R. and Newman, J.H. (2000) How Much Blood Is Really Lost in Total Knee Arthroplasty? Correct Blood Loss Management Should Take Hidden Loss into Account. Knee, 7, 151-155. [Google Scholar] [CrossRef
[6] Erskine, J.G., Fraser, C., Simpson, R., et al. (1981) Blood Loss with Knee Joint Replacement. Journal of the Royal College of Surgeons of Edinburgh, 26, 295-297.
[7] Pattison, E., Protheroe, K., Pringle, R.M., et al. (1973) Reduction in Haemoglobin after Knee Joint Surgery. Annals of the Rheumatic Diseases, 32, 582-584. [Google Scholar] [CrossRef] [PubMed]
[8] Faris, P.M., Ritter, M.A., Keating, E.M., et al. (1991) Unwashed Filtered Shed Blood Collected after Knee and Hip Arthroplasties. The Journal of Bone and Joint Surgery, 73A, 1169-1178. [Google Scholar] [CrossRef
[9] Gross, J.B. (1983) Estimating Allowable Blood Loss: Corrected for Dilution. Anesthesiology, 58, 277-280. [Google Scholar] [CrossRef] [PubMed]
[10] Williams-Johnson, J.A., McDonald, A.H., Strachan, G.G., et al. (2010) Effects of Tranexamic Acid on Death, Vascular Occlusive Events, and Blood Transfusion in Trauma Patients with Significant Haemorrhage (CRASH-2): A Randomised, Placebo-Controlled Trial. West Indian Medical Journal, 59, 612-624.
[11] Ker, K., Edwards, P., Perel, P., et al. (2012) Effect of Tranexamic Acid on Surgical Bleeding: Systematic Review and Cumulative Meta-Analysis. BMJ, 344, 3054. [Google Scholar] [CrossRef] [PubMed]
[12] Xie, J., Hu, Q., Ma, J., et al. (2017) Multiple Boluses of Intravenous Tranexamic Acid to Reduce Hidden Blood Loss and the Inflammatory Response Following Enhanced-Recovery Primary Total Hip Arthroplasty: A Randomised Clinical Trial. The Bone & Joint Journal, 99, 1442-1449. [Google Scholar] [CrossRef
[13] Lei, Y., Huang, Q., Huang, Z., et al. (2018) Multiple-Dose Intravenous Tranexamic Acid Further Reduces Hidden Blood Loss after Total Hip Arthroplasty: A Randomized Controlled Trial. The Journal of Arthroplasty, 33, 2940-2945. [Google Scholar] [CrossRef] [PubMed]
[14] Liu, X., Liu, J. and Sun, G. (2017) A Comparison of Combined Intravenous and Topical Administration of Tranexamic Acid with Intravenous Tranexamic Acid Alone for Blood Loss Reduction after Total Hip Arthroplasty: A Meta-Analysis. International Journal of Surgery, 41, 34-43. [Google Scholar] [CrossRef] [PubMed]
[15] Vles, G.F., Corten, K., Driesen, R., et al. (2020) Hidden Blood Loss in Direct Anterior Total Hip Arthroplasty: A Prospective, Double Blind, Randomized Controlled Trial on Topical versus Intravenous Tranexamic Acid. Musculoskeletal Surgery. [Google Scholar] [CrossRef] [PubMed]
[16] Ni, J.R., Wang, L.X. and Chen, X.J. (2016) Comparison of Different Modes of Using Tranexamic Acid Administration on Reducing Hidden Blood Loss in Total Hip Arthroplasty. China Journal of Orthopaedics and Traumatology, 29, 713-717.
[17] Zhang, P., Liang, Y., Chen, P., et al. (2017) Combined Application versus Topical and Intravenous Application of Tranexamic Acid Following Primary Total Hip Arthroplasty: A Meta-Analysis. BMC Musculoskeletal Disorder, 18, 90. [Google Scholar] [CrossRef] [PubMed]
[18] Wang, Z. and Zhang, H.J. (2018) Comparative Effectiveness and Safety of Tranexamic Acid plus Diluted Epinephrine to Control Blood Loss during Total Hip Arthroplasty: A Meta-Analysis. Journal of Orthopaedic Surgery and Research, 13, 242. [Google Scholar] [CrossRef] [PubMed]
[19] Teng, Y., Ma, J., Ma, X., et al. (2017) The Efficacy and Safety of Epinephrine for Postoperative Bleeding in Total Joint Arthroplasty: A PRISMA-Compliant Meta-Analysis. Medicine (Baltimore), 96, e6763. [Google Scholar] [CrossRef
[20] Cao, G., Huang, Q., Huang, Z., et al. (2019) The Efficacy and Safety of Multiple-Dose Oral Tranexamic Acid on Blood Loss Following Total Hip Arthroplasty: A Randomized Controlled Trial. International Orthopaedics, 43, 299-305. [Google Scholar] [CrossRef] [PubMed]
[21] Kayupov, E., Fillingham, Y.A., Okroj, K., et al. (2017) Oral and Intravenous Tranexamic Acid Are Equivalent at Reducing Blood Loss Following Total Hip Arthroplasty: A Randomized Controlled Trial. Journal of Bone and Joint Surgery, 99, 373-378. [Google Scholar] [CrossRef
[22] Cao, G., Huang, Z., Xie, J., et al. (2018) The Effect of Oral versus Intravenous Tranexamic Acid in Reducing Blood Loss after Primary Total Hip Arthroplasty: A Randomized Clinical Trial. Thrombosis Research, 164, 48-53. [Google Scholar] [CrossRef] [PubMed]
[23] Clagett, G.P., Anderson, F.A., Heit, J., et al. (1995) Prevention of Venous Thromboembolism. Chest, 108, 312S-334S. [Google Scholar] [CrossRef
[24] Haake, D.A. and Berkman, S.A. (1989) Venous Thromboembolic Disease after Hip Surgery. Risk Factors, Prophylaxis and Diagnosis. Clinical Orthopaedics and Related Research, 242, 212-231. [Google Scholar] [CrossRef
[25] (1986) Prevention of Venous Thrombosis and Pulmonary Embolism. National Institutes of Health Consensus Development Conference Statement, 6, 1-8.
[26] 李军, 荆珏华, 周云, 等. 利伐沙班和依诺肝素钠对人工全膝关节置换术后失血风险的影响比较[J]. 中国修复重建外科杂志, 2014, 28(1): 26-29.
[27] 高乐才, 武永东, 邵明星, 等. 低分子肝素及利伐沙班对全髋关节置换术后隐性失血的影响[J]. 现代中西医结合杂志, 2014, 23(22): 2453-2455.
[28] 肖学峰. 复元活血汤治疗生物型全髋关节置术后隐性失血气滞血瘀证的临床疗效观察[D]: [硕士学位论文]. 长沙: 湖南中医药大学, 2019.
[29] 邱庆虎, 马松涛, 李印鹏, 等. 八珍汤对老年全髋关节置换术后隐性失血的影响[J]. 中国中医骨伤科杂志, 2019, 27(1): 27-30.
[30] 肖署阳, 蔡立民, 谭志超, 等. 三七止血汤治疗人工全髋关节置换术围手术期失血临床研究[J]. 新中医, 2020, 52(2): 89-92.
[31] 吴泽庭. 归脾汤对单侧全髋关节置换术围手术期隐性失血的影响研究[D]: [硕士学位论文]. 杭州: 浙江中医药大学, 2019.