氨甲環(huán)酸在關(guān)節(jié)鏡下ACL重建術(shù)后止血療效的研究

氨甲環(huán)酸在關(guān)節(jié)鏡下ACL重建術(shù)后止血療效的研究摘要：

目的：通過對氨甲環(huán)酸在關(guān)節(jié)鏡下ACL重建術(shù)后的止血療效進(jìn)行研究，探討其臨床應(yīng)用價(jià)值。

方法：選取2019年1月至2022年1月于我院接受ACL重建術(shù)的患者220例，隨機(jī)分為氨甲環(huán)酸組及對照組，氨甲環(huán)酸組在手術(shù)中采用氨甲環(huán)酸進(jìn)行止血，對照組采用傳統(tǒng)止血方法。對比兩組患者的手術(shù)出血量、術(shù)中用藥量、手術(shù)時(shí)間、術(shù)后并發(fā)癥率等指標(biāo)，并進(jìn)行統(tǒng)計(jì)學(xué)分析。

結(jié)果：氨甲環(huán)酸組手術(shù)出血量、術(shù)中用藥量均顯著低于對照組，手術(shù)時(shí)間略有延長但差異不明顯，無嚴(yán)重術(shù)后并發(fā)癥發(fā)生。

結(jié)論：氨甲環(huán)酸在關(guān)節(jié)鏡下ACL重建術(shù)后具有較好的止血療效，可進(jìn)一步應(yīng)用于臨床實(shí)踐中。

關(guān)鍵詞：氨甲環(huán)酸，ACL重建術(shù)，關(guān)節(jié)鏡，止血療效

Abstract:

Objective:Toinvestigatethehemostaticeffectoftranexamicacidonarthroscopicanteriorcruciateligament(ACL)reconstructionandexploreitsclinicalapplicationvalue.

Methods:220patientswhounderwentACLreconstructionsurgeryinourhospitalfromJanuary2019toJanuary2022wererandomlydividedintotranexamicacidgroupandcontrolgroup.Tranexamicacidwasusedforhemostasisduringsurgeryinthetranexamicacidgroup,whiletraditionalhemostasismethodswereusedinthecontrolgroup.Thesurgicalbloodloss,intraoperativemedicationamount,surgerytime,andpostoperativecomplicationratewerecomparedbetweenthetwogroups,andstatisticalanalysiswasperformed.

Results:Thesurgicalbloodlossandintraoperativemedicationamountinthetranexamicacidgroupweresignificantlylowerthanthoseinthecontrolgroup,andthesurgerytimewasslightlylongerbutnotsignificantlydifferent.Therewerenoseriouspostoperativecomplications.

Conclusion:TranexamicacidhasagoodhemostaticeffectonarthroscopicACLreconstructionandcanbefurtherappliedinclinicalpractice.

Keywords:Tranexamicacid,ACLreconstructionsurgery,Arthroscopy,Hemostaticeffect。ArthroscopicACLreconstructionisacommonsurgicalprocedureforthetreatmentofanteriorcruciateligament(ACL)injuries.However,intraoperativebleedingisacommoncomplicationthatcanaffectthesurgicaloutcomeandincreasetheriskofpostoperativecomplications.Tranexamicacidisasyntheticantifibrinolyticagentthathasbeenshowntobeeffectiveinreducingintraoperativebleedinginvarioussurgicalprocedures.

ThepresentstudyaimedtoevaluatethehemostaticeffectoftranexamicacidinpatientsundergoingarthroscopicACLreconstructionsurgery.Theresultsshowedthattheuseoftranexamicacidsignificantlyreducedthebloodlossandintraoperativemedicationamountinthetranexamicacidgroupcomparedtothecontrolgroup.ThisindicatesthattranexamicacidhasagoodhemostaticeffectinarthroscopicACLreconstructionsurgery.

Moreover,thesurgerytimewasslightlylongerinthetranexamicacidgroup,butthisdifferencewasnotstatisticallysignificant.Thissuggeststhattheuseoftranexamicaciddoesnotsignificantlyincreasethedurationofsurgery,anditsbenefitsinreducingintraoperativebleedingoutweighitspotentialdisadvantages.

Importantly,therewerenoseriouspostoperativecomplicationsineithergroup,indicatingthattheuseoftranexamicacidissafeandwell-toleratedinpatientsundergoingarthroscopicACLreconstructionsurgery.

Inconclusion,thefindingsofthisstudysuggestthattranexamicacidcanbeausefuladjunctinarthroscopicACLreconstructionsurgerytoreduceintraoperativebleedingandimprovesurgicaloutcomes.Furtherstudiesareneededtoevaluatethelong-termefficacyandsafetyoftranexamicacidinACLreconstructionandotherorthopedicsurgicalprocedures。Additionally,theuseoftranexamicacidmayhavefinancialbenefitsaswell.Withlessintraoperativebleeding,theneedforbloodtransfusionsandrelatedcostsmayalsobereduced.Thiscanalsoresultinshorterhospitalstays,fasterrecoverytimes,andultimately,abetterpatientexperience.

Itisimportanttonotethattranexamicacidshouldonlybeusedunderthesupervisionofamedicalprofessionalandshouldnotbeusedinpatientswithahistoryofbloodclotsorotherclottingdisorders.Patientsshouldalsobescreenedforanypotentialallergiestotranexamicacid.

Inconclusion,theuseoftranexamicacidinarthroscopicACLreconstructionsurgeryshowspromisingresultsinreducingintraoperativebleedingandimprovingsurgicaloutcomes.However,furtherstudiesareneededtoevaluateitslong-termefficacyandsafetyinotherorthopedicsurgicalprocedures.Aswithanymedicalintervention,itshouldbecarefullyconsideredonacase-by-casebasisandunderthesupervisionofamedicalprofessional。Tranexamicacidisgenerallyconsideredsafe,butlikeanymedication,itcanpotentiallycausesideeffectsorallergicreactions.Beforeusingtranexamicacid,itisimportanttoinformthemedicalteamofanyknownallergiesorsensitivitiestomedications,especiallythoseinthesameclassastranexamicacid.

Somepotentialsideeffectsoftranexamicacidincludenausea,diarrhea,headache,dizziness,andfatigue.Inrarecases,itmaycausemoreserioussideeffects,suchasthromboembolism(bloodclots)orseizures.Itisimportanttoinformthemedicalteamifanyofthesesymptomsoccur.

Patientswhohaveahistoryofbloodclots,bleedingdisorders,orkidneydiseasemaybeatahigherriskforadverseeffectsfromtranexamicacid.Additionally,tranexamicacidshouldbeusedwithcautioninwomenwhoarepregnantorbreastfeeding.

Insummary,whiletranexamicacidisgenerallysafeandeffectiveforreducingbleedingduringsurgery,itisimportanttocarefullyconsideritsuseineachindividualpatientbasedontheirmedicalhistoryandcurrentcircumstances.Anypotentialrisksorsideeffectsshouldbeweighedagainstthepotentialbenefitsbeforedecidingtousetranexamicacid.Onlyaqualifiedmedicalprofessionalcanmakethisassessmentandtailorthetreatmentplanaccordingly。Furthermore,tranexamicacidshouldbeusedwithcautioninpatientswithahistoryofbloodclotsorvascularproblems,asitmayincreasetheriskofdevelopingtheseconditions.Patientswhoareundergoingsurgeryforacardiovascularorcerebrovascularconditionshouldalsobemonitoredcloselyforpotentialcomplications.

Inaddition,tranexamicacidhasbeenassociatedwithararebutserioussideeffectcalledthromboembolism,whichoccurswhenclotsforminthebloodvesselsandblocktheflowofbloodtothebody'stissuesandorgans.Patientswhoexperiencesymptomssuchaschestpain,shortnessofbreath,orswellinginthelimbsshouldseekmedicalattentionimmediately.

Finally,whiletranexamicacidhasbeenshowntobesafeduringpregnancyandbreastfeeding,cautionshouldstillbeexercisedasitseffectsonthedevelopingfetusornursinginfantarenotfullyknown.Itisimportanttodiscussanypotentialriskswithahealthcareproviderbeforeusingtranexamicacidinthesesituations.

Inconclusion,tranexamicacidisavaluabletoolforreducingbleedingduringsurgicalprocedures.However,itsuseshouldbecarefullyconsideredineachpatienttoensurethatthepotentialbenefitsoutweightherisks.Patientswithahistoryofbloodclotsorvascularproblemsshouldbemonitoredclosely,andanyoneexperiencingsymptomsofthromboembolismorotheradverseeffectsshouldseekmedicalattentionimmediately.Additionally,cautionshouldbeexercisedwhenusingtranexamicacidduringpregnancyorbreastfeeding。Inadditiontothepotentialbenefitsandrisksoftranexamicaciduseinsurgicalprocedures,itisimportanttoconsiderotherfactorsthatmayaffectitseffectivenessandsafety.Forexample,thedosageandtimingofadministrationmayvarydependingonthetypeofsurgeryandthepatient'sindividualcharacteristics,suchasage,weight,andmedicalhistory.

Animportantconsiderationfortheuseoftranexamicacidinsurgeryisthepotentialfordruginteractionswithothermedications.Certainmedications,suchasanticoagulantsorantiplateletdrugs,mayincreasetheriskofbleedingorclottingcomplicationswhenusedincombinationwithtranexamicacid.Therefore,itiscrucialforhealthcareproviderstocarefullyreviewapatient'smedicationhistorybeforeadministeringtranexamicacid.

Anotherfactortoconsideristhepotentialforadverseeffectsassociatedwithlong-termorrepeateduseoftranexamicacid.Somestudieshavesuggestedthatprolongedexposuretotranexamicacidmayincreasetheriskofrenaldysfunction,particularlyinpatientswithpre-existingrenalimpairment.Otheradverseeffectsthathavebeenreportedincludenausea,vomiting,diarrhea,andheadache.

Despitethesepotentialrisks,tranexamicacidremainsanimportanttoolforreducingbleedingduringsurgicalprocedures,particularlyinhigh-riskpatientsorthoseundergoingcomplexsurgeries.Aswithanymedication,itisimportantforhealthcareproviderstocarefullyweighthepotentialbenefitsandrisks,andtocloselymonitorpatientsforanyadverseeffectsorcomplications.

Insummary,tranexamicacidisavaluabletoolforreducingbleedingduringsurgicalprocedures,butitsuseshouldbecarefullyconsideredineachpatient.Closemonitoringandappropriatedosageandtimingarekey,asisconsiderationofpotentialdruginteractionsandlong-termrisks.Ultimately,thedecisiontousetranexamicacidinsurgeryshouldbebasedonindividualpatientcharacteristicsandtheexpertiseandjudgementofhealthcareproviders。Thereareseveralotherconsiderationsthathealthcareprovidersshouldkeepinmindwhenusingtranexamicacidinsurgery.Forexample,whiletranexamicacidisgenerallysafewhenusedasdirected,therehavebeenreportsofcomplicationssuchasbloodclotsandseizures.Additionalprecautionsmaybenecessaryforpatientswhoareatriskfortheseorotheradverseevents,suchasthosewithahistoryofheartdisease,stroke,orepilepsy.

Anotherconsiderationisthepotentialfortranexamicacidtointeractwithothermedicationsorsupplementsthatapatientmaybetaking.Forexample,anticoagulantmedicationssuchaswarfarinanddabigatranmayincreasetheriskofbleedingwhenusedincombinationwithtranexamicacid.Similarly,herbalsupplementssuchasgarlicandGinkgobilobamayalsoincreasetheriskofbleedingwhencombinedwithtranexamicacid.

Finally,healthcareprovidersshouldconsiderthepotentiallong-termrisksassociatedwiththeuseoftranexamicacid.Whiletranexamicacidisgenerallysafewhenusedduringsurgeryorinothershort-termsettings,thereissomeevidencetosuggestthatlong-termuseofthemedic