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氨甲环酸联合明胶海绵对Sanders Ⅲ、Ⅳ型跟骨骨折术后出血的影响

崔斌,刘彬*,张磊,杨萌国,王争刚,郭永良   

  1. 陕西省核工业215医院创伤骨科,陕西省核工业215医院创伤骨科,陕西省核工业二一五医院创伤骨科,陕西省核工业二一五医院创伤骨科,陕西省核工业二一五医院创伤骨科,陕西省核工业二一五医院创伤骨科
  • 收稿日期:2019-05-23 修回日期:2019-07-01 出版日期:2019-07-25

Effect of Tranexamic Acid Combined with Gelatin Sponge on Postoperative Bleeding of Sanders Ⅲ and Ⅳ Calcaneal Fractures

CUI Bin,LIU Bin,ZHANG Lei,YANG Mengguo,WANG Zhenggang and GUO Yongliang   

  1. 215 Hospital of Shaanxi Nuclear Industry,215 Hospital of Shaanxi Nuclear Industry,Department of Trauma and Orthopedics, No. 215 Hospital of Shaanxi Nuclear Industry,Department of Trauma and Orthopedics, No. 215 Hospital of Shaanxi Nuclear Industry,Department of Trauma and Orthopedics, No. 215 Hospital of Shaanxi Nuclear Industry,Department of Trauma and Orthopedics, No. 215 Hospital of Shaanxi Nuclear Industry
  • Received:2019-05-23 Revised:2019-07-01 Online:2019-07-25

摘要: 目的: 探讨氨甲环酸联合明胶海绵对SandersⅢ、Ⅳ型跟骨骨折术后出血的影响。方法: 选取2017年1月至2018年12月在我院骨科跟骨骨折分型为SandersⅢ、Ⅳ型并行切开复位内固定的患者30例,随机将30例患者分为对照组与实验组(各15例)。实验组手术在跟骨髓腔内外置入浸润氨甲环酸注射液的明胶海绵,对照组手术跟骨髓腔内外不填充任何止血材料。观察两组患者手术时间、术中出血量、术后24 h及48 h引流量、伤口愈合情况。结果:本研究中30例跟骨骨折患者中26例患者跟骨骨折术后伤口一期愈合并顺利拆线出院。有4例伤口出现延迟愈合,3例为对照组,1例为实验组。两组患者年龄、性别、体质指数、手术时间及术中出血量差异均无统计学意义(P>0.05),而术后伤口引流量实验组低于对照组,差异有统计学意义(P<0.05)。结论: 氨甲环酸联合明胶海绵能有效减少SandersⅢ、Ⅳ型跟骨骨折术后出血量。

Abstract: Objective: To investigate the effect of tranexamic acid combined with gelatin sponge on postoperative bleeding of Sanders Ⅲ and Ⅳ calcaneal fractures. Methods: From January 2017 to December 2018, 30 patients with calcaneal fractures who were classified as Sanders Ⅲ and Ⅳ type and had open reduction and internal fixation in our hospital were randomly divided into the control group and the experimental group, each group 15 cases . Tranexamic acid combined with gelatin sponge were used in the calcaneal bone marrow cavity in the experimental group and hemostatic materials were not used in the calcaneal bone marrow cavity in the control group. The operation time, intra-operative blood loss, drainage volume at 24 h and 48 h after operation, and wound healing were observed. Results: In this study, 26 of the 30 patients with calcaneal fractures healed by first intention after operation and successfully discharged. There were 4 cases of delayed healing of wound, 3 cases in the control group and 1 case in the experimental group. There were no significant difference in age, gender, body mass index, operative time, and intra-operative blood loss between the patients of the two groups (P>0.05). However, the postoperative drainage tube drainage results showed that the drainage volume of the experimental group was significantly lower than that of the control group, and the difference was statistical significant (P<0.05). Conclusion: Tranexamic acid combined with gelatin sponge can effectively reduce the amount of postoperative bleeding in Sanders Ⅲ and Ⅳ calcaneal fractures.