Page 90 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第44卷第6期
·826 · Journal of Nanjing Medical University（Natural Sciences） 2024年6月

·临床研究·

促红细胞生成素联合氨甲环酸改善股骨粗隆间骨折围手术期贫

血及失血的疗效与安全性分析

马庆宏，张 润，严旭东，孙 超 *

南京医科大学附属江宁医院骨科，江苏 南京 211100

［摘 要］ 目的：探究促红细胞生成素（erythropoietin，EPO）联合氨甲环酸（tranexamic acid，TXA）改善股骨粗隆间骨折（inter⁃
trochanteric fracture，IF）患者围手术期贫血及减少围术期失血的疗效及安全性。方法：分析2018年1月—2023年1月在南京医
科大学附属江宁医院因IF手术的患者174例，依据治疗情况分为3组：对照组（A组）62例；仅使用TXA组（B组）57例；TXA联
合EPO组（C组）55例。收集3组患者入院时及术前术后血红蛋白（haemoglobin，Hb）量、术中总失血量、显/隐性失血量、围手术
期输血率及输血量、住院时间及血栓等并发症情况。结果：3组入院时Hb量差异无统计学意义；C组术前及术后2、5 d的Hb量
与A组及B组相比，明显改善；C组总失血量、输血率及输血量均低于A组，差异均有统计学意义（P < 0.05）。术后3组血栓等并发
症发生率比较，差异无统计学意义（P > 0.05）。结论：术中静脉和局部联用TXA和EPO能有效减少IF患者围手术期失血及输血
率，缩短住院时间及降低住院费用，且不增加血栓等并发症的风险。
［关键词］ 股骨粗隆间骨折；贫血；氨甲环酸；促红细胞生成素

［中图分类号］ R687.3；R556 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）06⁃826⁃06
doi：7655/NYDXBNSN240063

Efficacy and safety of combined treatment with tranexamic acid and erythropoietin to
improve perioperative anemia and blood loss during surgery for intertrochanteric fractures
*
MA Qinghong，ZHANG Run，YAN Xudong，SUN Chao
Department of Orthopaedics，the Affiliated Jiangning Hospital of Nanjing Medical University，Nanjing 211100，China

［Abstract］ Objective：To assess the effectiveness and safety of combined treatment with tranexamic acid（TXA）and erythropoietin
（EPO）during the surgery for intertrochanteric fracture（IF）. Methods：A total of 174 patients with IF underwent surgery admitted to
the Affiliated Jiangning Hospital of Nanjing Medical University from January 2018 to January 2023 were enrolled in this study. The
patients were randomly divided into 3 groups：control group（Group A，n=62），TXA alone group（Group B，n=57），and TXA combined
with EPO group（Group C，n=55）. Perioperative total blood loss，obvious blood loss and hidden blood loss in the three groups were
calculated separately. The blood transfusion rate and blood transfusion volume，haemoglobin（Hb）levels，hospitalization day，and
complications such as thrombosis were recorded. Results：There was no significant difference in Hb levels between three groups on
admission. The Hb levels in Group C were significantly improved compared to the other two groups before surgery，2 and 5 days after
surgery（P < 0.05）. The total blood loss，transfusion rate，and transfusion volume in Group C were all lower than those in Group A，and
the differences were statistically significant（P < 0.05）. There was no statistically significant difference in the incidence of thrombosis
and other complications among three groups（P > 0.05）. Conclusion：The combined use of TXA and EPO intravenously and locally
during surgery significantly reduces perioperative blood loss and blood transfusion rate，shortens hospital stays，lowers hospitalization
costs，and does not increase the risk of complications such as thrombosis，in patients with IF.
［Key words］ intertrochanteric fracture；anaemia；tranexamic acid；erythropoietin
［J Nanjing Med Univ，2024，44（06）：826⁃831］

［基金项目］ 国家自然科学基金（81802198）；江苏省自然科学基金（BK20221176）；江宁区科技惠民计划项目（2022104S）
∗
通信作者（Corresponding author），E⁃mail：drsunchao@163.com