赵婷 张维斌 唐艳 蒲川

中圖分类号 R969.3 文献标志码 A 文章编号 1001-0408（2021）13-1622-05

DOI 10.6039/j.issn.1001-0408.2021.13.15

摘 要 目的：了解氨甲环酸在骨科住院患者中的应用现状及趋势，为临床合理用药提供参考。方法：对重庆市4家三级甲等医院骨科的3个亚科室（关节外科、脊柱外科、创伤骨科）2017-2020年氨甲环酸的使用量、氨甲环酸使用患者的骨科疾病种类分布以及氨甲环酸使用方法等数据进行分析。结果：4年期间骨科氨甲环酸总使用量逐年递增，增幅为6.2%～52.2%，各科室使用量亦逐年递增;2017-2019年关节外科使用量占比最大（分别为59.2%、53.5%、47.2%），2020年创伤骨科使用量占比最大（39.2%）。整体而言，氨甲环酸在不同种类骨科疾病患者中的使用量占比排前4位的依次为关节置换（25.5%～29.6%）、髋部骨折（19.3%～23.6%）、骨干骨折（13.5%～18.6%）以及骨盆髋臼骨折（8.2%～14.0%）;各年度脊柱外科、关节外科以及创伤骨科的氨甲环酸使用方法始终以单纯静脉给药为主（占比分别为55.1%～81.0%、46.9%～77.1%、49.3%～73.3%、44.9%～71.5%）。结论：氨甲环酸在骨科住院患者中的使用量呈明显的逐年增长趋势，且以关节外科、创伤骨科使用为主导;其使用方法仍以单纯静脉给药为主，较为安全可靠。

关键词 氨甲环酸;骨科;亚科室;使用量;疾病种类;用法

Application Analysis of Tranexamic Acid in the Orthopedic Inpatients from 4 Third-grade Class-A Hospitals in Chongqing

ZHAO Ting1，ZHANG Weibin2，TANG Yan2，PU Chuan1（1. School of Public Health and Management， Chongqing Medical University， Chongqing 400016， China; 2. Dept. of Surgical Oncology， Childrens Hospital of Chongqing Medical University， Chongqing 400014， China）

ABSTRACT   OBJECTIVE： To investigate the application and trend of tranexamic acid in the orthopedic inpatient， and to provide reference for rational drug use. METHODS： The consumption of tranexamic acid， the distribution of orthopedics diseases using tranexamic acid and route of administration were analyzed in 3 sub-departments （joint surgery department， spinal surgery department， orthopedic trauma department） from 4 third-grade class-A hospitals of Chongqing during 2017 to 2020. RESULTS： The total consumption of tranexamic acid used in orthopaedic department had increased year by year in the past 4 years， with increase of 6.2%-52.2%， and the consumption of tranexamic acid in various departments also increased year by year; from 2017 to 2019， joint surgery department accounted for the largest proportion （59.2%， 53.5%， 47.2%） to use tranexamic acid， and orthopedic trauma department accounted for the largest proportion （39.2%） in 2020. On the whole， top 4 orthopedic diseases in the list of the consumption of tranexamic acid were joint replacement（25.5%-29.6%）， hip fracture（19.3%-23.6%）， diaphysis fracture （13.5%-18.6%） and pelvic and acetabular fracture （8.2%-14.0%）. The route of administration for tranexamic acid in spinal surgery department， joint surgery department and orthopedic trauma department was mainly intravenous application every year（accounting for 55.1%-81.0%， 46.9%-77.1%， 49.3%-73.3%， 44.9%-71.5%）.  CONCLUSIONS： The consumption of tranexamic acid in orthopedic inpatients is increased year by year， and is dominated by joint surgery department and orthopedic trauma department. The route of tranexamic acid is still mainly intravenous administration， which is safe and reliable.

KEYWORDS   Tranexamic; Orthopedic department; Sub-department; Consumption; Disease types; Route of administration

氨甲环酸是一种人工合成的低分子量赖氨酸类似物，半衰期为 80～120 min;其可竞争性地与纤溶酶原/纤溶酶的赖氨酸结合位点结合，从而阻碍活化的纤溶酶与纤维蛋白结合，抑制纤溶酶对纤维蛋白的降解[1]。氨甲环酸能有效减少术中出血并降低围手术期血制品的输注率，相比抑肽酶等其他抗纤溶药物的安全性较高[2]。……