Impact of different approaches using tranexamic acid on hidden blood loss after femoral intertrochanteric fracture fixation with PFNA-Ⅱ
ZHOU Shu-qing
ZHU Qiu-wen
ZHU Ming
ZHANG Xiao-hua
NI Wei-dong
Abstract：Objective To evaluate the efficacy and safety of different approaches using tranexamic acid(TXA)to reduce obvious and hidden blood loss after femoral intertrochanteric fracture fixation with PFNA -Ⅱ. Methods A total of 177 femoral intertrochanteric fracture patients treated with PFNA-Ⅱ in the Jiangjin Centre Hospital between Jan.2015 and May 2015 were randomly divided into three groups.Intravenous group(A): 2g (200mL)tranexamic acid was given 10 minutes before operation in 59 cases.Combined group(B):1g(100mL) tranexamic acid was intravenously given before operation,and then other 1g(100mL)was given in the articular cav-ity in 59 cases.Control group(C):tranexamic acid was not given.The obvious blood loss,hidden blood loss,total perioperative blood loss,transfusion rate and complications of vascular events were compared among the three groups.Results Hidden blood loss in groups A,B,and C was(617.18 ±184.93)mL,(555.62 ±135.49)mL and (679.63 ±165.75)mL,respectively,with significant difference between groups A and B(P<0.05),between groups A and C(P<0.05)and between groups B and C(P<0.01).Moreover,the perioperative total blood loss was(699.32 ±188.94)mL in group A,(636.58 ±134.41)mL in group B,and(760.97 ±165.99)mL in group C.The volume of hidden blood loss and total blood loss in group A and B were less than those in group C,which was less in group B than in group A(P<0.05).The obvious blood loss of three groups were similar(P>0.05). Doppler ultrasonography on the postoperative day 7 showed 3 cases of venous thrombosis in legs in group A (5.08%),2 cases of venous thrombosis in legs in group B(3.39%),and 1 case of iliac vein thrombosis,1 case of colorectal vein thrombosis in group C(3.39%).The difference was not statistically significant(P>0.05).Con-clusion Combined use of TXA can significantly reduce hidden blood loss and transfusion rate after intertrochanteric fracture with PFNA-Ⅱinternal fixation,which does not increase risks of vascular events complications.
Keywords：femoral intertrochanteric fractureproximal femoral nail antirotationhidden blood losstranexamic acid
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 358-362 )