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《The Journal of Traditional Chinese Orthopedics and Traumatology》 2016-01
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Effect of preoperative intravenous drip infusion and intraoperative intra-articular injection of tranexamic acid on perioperative blood loss of total knee arthroplasty

WANG Qingdong;LI Fubin;XU Xiangfeng;LI Jiefeng;JIN Yannan;KANG Le;PENG Gaofeng;The Second Affiliated Hospital of Luohe medical high training school;  
Objective: To observe the effect of preoperative intravenous drip infusion and intraoperative intra- articular injection of tranexamic acid( TXA) on perioperative blood loss of total knee arthroplasty( TKA). Methods: Sixty-four patients with unilateral knee osteoarthritis who were treated with TKA were randomly divided into combination group and intra- articular injection group,32 cases in each group. The two groups were completely consistent with each other in the operative procedures and the selected prosthesis. The patients in combination group were treated with intravenous drip infusion of TXA( 1 g) at 10 min before tourniquet inflated and antidromic intra- articular injection of TXA( 2 g) through the drainage tube after the fascia were sutured. Moreover,the drainage tubes were closed for 2 hours. The patients in intra- articular injection group were only treated with the monotherapy of antidromic intra- articular injections of TXA. The postoperative drainage,total blood loss and incidence rate of lower extremity deep venous thrombosis( DVT) were measured and compared between the 2 groups. Results: There was no statistical difference in the operation time and the postoperative drainage between the 2 groups( 62. 9 +/- 4. 1 vs 63. 8 +/- 4. 0 min,t =- 0. 526,P = 0. 601; 121. 00 +/- 26. 00 vs 132. 00 +/- 28. 00 m L,t =- 1. 638,P = 0. 107). The total blood loss of combination group was less than that of intra- articular injection group at 4 days after the surgery( 500. 00 + /- 116. 00 vs589. 00 + /- 108. 00 m L,t =- 3. 078,P = 0. 002). DVT was found in combination group( 2 cases) and intra- articular injection group( 1case) within 7 days postoperatively,and the 3 cases were diagnosed as surae intermuscular venous thrombosis The anticoagulants were used in former dosage and the thrombus of the 3 patients disappeared at 2 weeks after the surgery. There was no statistical difference in the incidence rate of DVT between the 2 groups( χ2= 0. 000,P = 1. 000). Conclusion: Combination of preoperative intravenous drip infusion with intraoperative intra- articular injection of TXA can effectively reduce perioperative blood loss of TKA and do not increase the risk of DVT.
【CateGory Index】: R687.4
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