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《Journal of Traumatic Surgery》 2018-03
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Effects of tranexamic acid with different methods on blood loss in traumatic knee arthritis patients with total knee arthroplasty

GUO Huan-lai;YANG Jian-xiang;ZHAO Jie;FAN Yan-mei;WU Hong-yang;Department of Internal Medicine,the Second Hospital of Bazhou City;Department of Orthopaedics,the Second Hospital of Bazhou City;Dispensary for Western Medicine,the Second Hospital of Bazhou City;Langfang City Institute for Drug Control;  
Objective To explore the effects of tranexamic acid( TXA) with different methods on blood loss in traumatic knee arthritis patients with total knee arthroplasty( TKA). Methods Totally 128 cases of traumatic knee arthritis with unilateral TKA in the Second Hospital of Bazhou City from Jan. 2014 to Feb. 2017 were enrolled in this study. There were 36 males and 92 females,with an average age of 68. 2 years( mean,56-81 years).According to the digital method,all patients were assigned randomly to control group,intravenous drip group,cavity injection group,and local flushing group,with 32 cases in each group. The patients in control group were not treated with TXA,the patients in intravenous drip group received 0. 5 g TXA( diluted in 100 m L NS) at 15 min before the tourniquet deflation,the patients in cavity injection group were injected with 0. 5 g TXA through drainage tube after intraoperative suture of incision,and the patients in local flushing group were treated with flushing of 0. 5 g TXA( diluted in 250 m L NS) when the incision closed. Total blood loss,dominant blood loss and hidden blood loss,amount of blood transfusion,blood transfusion rates in the four groups were compared. The postoperative adverse events and complications were followed up. Results( 1) Gender ratio,average age,body mass index,hemoglobin before replacement,operation time and tourniquet using time in the four groups had no statistical difference( P 0. 05).( 2)Total blood loss,dominant blood loss,hidden blood loss,amount of blood transfusion,and blood transfusion rates in intravenous drip group and cavity injection group were less than those in local flushing group and control group( P 0. 05). The dominant blood loss in cavity injection group was less than those in intravenous drip group,local flushing group and control group. The hidden blood loss in intravenous drip group was less than those in cavity injection group,local flushing group and control group.( 3) Lower extremity deep vein thrombosis and pulmonary embolism did not happen after surgery. Conclusion Articular cavity injection of TXA can effectively reduce postoperative drainage,intravenous drip can effectively reduce hidden blood loss,and both can significantly reduce bleeding and postoperative blood transfusion.
【Fund】: 廊坊市科技支撑计划项目(2016013042)
【CateGory Index】: R687.4
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