Effect of combination using of tranexamic acid on reducing blood loss in aged total knee arthroplasty

SUN Kuo; XIE Li-feng; QIU Zhi-qiang; ZENG Xiao-bin

doi:10.3969/j.issn.1001-9448.2018.10.028

Abstract：Objective To evaluate the effect of combination of intravenous and topical use of tranexamic acid (TA) on blood loss reduction in patients with primary total knee arthroplasty during the perioperation period .Methods Sixty patients with primary total knee arthroplasty were randomized divided into two groups , intravenous tranexamic group (intravenous group, n＝30) and combination group (n＝30).The intravenous group received intravenous injection of TA (1 g, 10 minutes before the surgery ).The combination group received intravenous injection of TA , tropical use of TA in medullary cavity and articular cavity after operation .Temporary drainage tube closure was performed for 6 h after opera-tion.The drainage volumes were recorded , and the blood routine examination was taken on the 1st and the 3rd day after operation.Total blood loss, Hb 24 hours and 72 hours after operation, APTT, PT, D-dimer and thrombosis events were observed and recorded.Results The total blood loss and drainage volume in combination group were significantly less than those in intravenous group (P＜0.05).The hemoglobin values 24 hours and 72 hours after operation of combination group were significantly higher than those of intravenous group (P＜0.05).Compared with the intravenous group , the a-mount of blood transfusions and number of blood transfusions required were dramatically reduced in the combined group (P＜0.05).No acute infection around the prosthesis , lower extremity deep venous thrombosis , pulmonary embolism or other severe complications were observed in the 2 groups.Conclusion The combination of intravenous and topical TA use in TKA can effectively reduce total blood loss and number of blood transfusions required without increasing the risk of deep vein thrombosis or/and pulmonary embolism.