摘 要 目的：探讨局部与静脉使用氨甲环酸在全髋关节置换术中的效果，明确两者的差异。方法：回顾分析实施全髋关节置换术的患者案例40例，根据氨甲环酸给药方式分为局部使用氨甲环酸组(局部组)及静脉使用氨甲环酸组(静脉组)，每组20例。局部组采用关节腔内注射氨甲环酸；静脉组采用静脉滴注氨甲环酸。比较两组患者血红蛋白(Hb)水平及其变化量、输血率、住院时间和静脉血栓栓塞症(VTE)发生率的差异。结果：两组术中Hb水平、输血率、平均住院时间和VTE发生率比较，差异无统计学意义(P>0.05)。局部组术后第1天Hb水平高于静脉组，术后血红蛋白水平下降量及下降率均低于静脉组(P<0.05)。结论：全髋关节置换术中，与静脉滴注氨甲环酸相比，关节腔内局部注射氨甲环酸在改善术后出血效果更佳，且2种给药方式均不会增加VTE发生风险。

    关键词 氨甲环酸 全髋关节置换术 失血 静脉血栓栓塞症

    中图分类号：R973.1； R687.42 文献标志码：B 文章编号：1006-1533(2024)07-0056-03

    引用本文 林奕伦， 张灿洪， 杨小明， 等. 局部与静脉使用氨甲环酸在全髋关节置换术中的效果比较[J]. 上海医药， 2024， 45(7)： 56-58； 66.

    Efficacy of topical versus intravenous tranexamic acid in total hip arthroplasty

    LIN Yilun， ZHANG Canhong， YANG Xiaoming， SHI Jianhui， WEN Bo

    (Department of Orthopaedics， the First Hospital of Quanzhou， Quanzhou 361001， China)

    ABSTRACT Objective： To explore the efficacy of topical and intravenous tranexamic acid in total hip arthroplasty， and clarify the difference between them. Methods： Forty cases of patients who underwent total hip arthroplasty were retrospectively analyzed and divided into a tranexamic acid administration group (topical group) and an intravenous drip of tranexamic acid group (intravenous group) according to their administration method with 20 cases each. The topical injection of tranexamic acid in the joint cavity was adopted in the topical group while the intravenous drip of tranexamic acid was used in the intravenous group. Differences in hemoglobin (Hb) level and its amount of change ......