Effect and safety analysis of intraoperative application of tranexamic acid on blood loss after total knee arthroplasty

ZHANG Nan; WENG Run-min

doi:10.3969/j.issn.1009-4237.2017.08.006

Abstract：Objective To explore the effect and safety of applying acid tranexamic intraoperatively on blood loss after total knee arthroplasty. Methods Totally 75 patients who underwent total knee replacement surgery from Sep.2013 to Apr.2016 in our hospital were selected.They were divided into three groups with 25 cases in each group according to the stochastic method.Group A was given intravenous tranexamic acid for treatment, group B was given intra-articular injection of tranexamic acid after joint capsule suture, and group C was given treatment which combined intra-articular injection with intravenous tranexamic acid.Hemoglobin within 72 h after surgery, the amount of bleeding, the overt blood loss, blood transfusion, coagulation changes, skin surface bruising and deep vein thrombosis of patients were observed and compared. Results The postoperative hemoglobin of three groups decreased significantly compared with preoperative level (P<0.05).And there was no significant difference in hemoglobin of group A and group B (P> 0.05).The hemoglobin of group C after 16 h was significantly higher than group A and group B (P<0.05).Postoperative bleeding volume in group C after 16 h stabilized, significantly higher than group A and group B, and overt blood loss and blood transfusion of group C were better than group A and group B (P<0.05).There was no significant difference in postoperative coagulation at 3 h for three groups (P>0.05), and no patient with deep venous thrombosis was found.The rate of body surface petechiae patients in group C was significantly lower than group A and group B(P<0.05). Conclusion Intra-articular injection combined with intravenous tranexamic acid can significantly reduce the amount of bleeding in total knee replacement surgery patients and have high security,which is worthy of promotion.