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甲泼尼龙联合氨甲环酸在全髋关节置换术加速康复中的临床应用。

Clinical utilization of methylprednisolone in conjunction with tranexamic acid for accelerated rehabilitation in total hip arthroplasty.

机构信息

Department of Traumatology and Orthopaedics, Hezhou People's Hospital, Guangxi Zhuang Autonomous Region, Hezhou, China.

出版信息

J Orthop Surg Res. 2023 Oct 4;18(1):747. doi: 10.1186/s13018-023-04249-8.

Abstract

PURPOSE

This study aimed to evaluate the efficacy and safety of combined methylprednisolone (MP) and tranexamic acid (TXA) in promoting accelerated rehabilitation following total hip arthroplasty (THA). We further investigated effective strategies for rapid rehabilitation post-THA.

METHODS

Conducted as a randomized controlled trial involving 80 patients, the study allocated subjects into two groups. The control group received saline and TXA, whereas the experimental group was administered with an additional dose of MP. Several clinical parameters, including markers of inflammation, pain, nausea, and coagulation factors, were meticulously assessed in both groups.

RESULTS

It was observed that the group receiving the MP + TXA treatment showcased significant reductions in postoperative levels of CRP and IL-6, as well as an alleviation in pain scores. Furthermore, this group demonstrated lower incidences of postoperative nausea and fatigue, facilitating enhanced hip joint mobility. Interestingly, this group did exhibit blood glucose fluctuations within the first 24 h postoperatively. However, there was no notable difference between the groups concerning transfusion rate, postoperative hospital stay duration, and coagulation profile, and no severe complications were reported.

CONCLUSION

The findings suggest that the combined administration of MP and TXA can appreciably enhance postoperative recovery, by reducing inflammatory markers, alleviating pain, reducing nausea and fatigue, and improving hip mobility, without leading to an increased risk of severe perioperative complications. This highlights the potential role of this combined therapy in facilitating improved postoperative patient experiences.

摘要

目的

本研究旨在评估甲泼尼龙(MP)联合氨甲环酸(TXA)在促进全髋关节置换术(THA)后加速康复方面的疗效和安全性。我们进一步探讨了 THA 后快速康复的有效策略。

方法

这是一项随机对照试验,共纳入 80 例患者,将受试者分为两组。对照组给予生理盐水和 TXA,实验组给予额外剂量的 MP。两组均仔细评估了多项临床参数,包括炎症标志物、疼痛、恶心和凝血因子。

结果

接受 MP+TXA 治疗的组在术后 CRP 和 IL-6 水平显著降低,疼痛评分减轻。此外,该组术后恶心和疲劳的发生率较低,髋关节活动度增强。有趣的是,该组在术后 24 小时内确实出现了血糖波动。然而,两组间的输血率、术后住院时间和凝血谱无显著差异,且均未报告严重并发症。

结论

这些发现表明,MP 和 TXA 的联合应用可通过降低炎症标志物、减轻疼痛、减少恶心和疲劳以及改善髋关节活动度,显著促进术后恢复,而不会增加严重围手术期并发症的风险。这凸显了这种联合治疗在促进术后患者体验改善方面的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1636/10548678/5b65b6ea0048/13018_2023_4249_Fig1_HTML.jpg

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