Effects of tranexamic acid on blood loss volume after total knee arthroplasty

doi:10.3969/j.issn.1002-7386.2016.17.002

Abstract：Objective To investigate the effects of tranexamic acid on blood loss volume after total knee arthroplasty ( TKA) ,and to observe its safety. Methods Sixty-two patients with knee osteoarthritis ( Kellgren-Lawrence grade Ⅳ) who underwent total knee replacement surgery in our hospital from January 2012 to January 2015 were randomly divided into trial group and control group,with 31 patients in each group. The patients in trial group were given tranexamic acid (10mg/kg) by intravenous drip after the prosthesis was assembled and in 10 minutes before tourniquet was removed, ang medication again after 3 hours at the same dose and medication way,however,the patients in control group were given equivalence 0. 9% sodium chloride solution. The intraoperative blood loss volume, postoperative total blood loss volume, postoperative dominance blood loss volume, postoperative recessive blood loss volume, postoperative total draining volume, blood transfusion volume of three days after the operation, blood coagulation indexes including prothrombin time, fibrinogen, activated partial thromboplastin time, D - dimer, and complications were detected and compared between two groups. Results There was no significant difference in the intraoperative blood loss volume between two groups ( P >0. 05). The postoperative blood loss volume, postoperative dominance blood loss volume, postoperative recessive blood loss volume, postoperative total draining volume, blood transfusion volume after the operation in trial group were significantly less than those in control group ( P <0. 05). However there were no significant differences in the prothrombin time, fibrinogen, activated partial thromboplastin time, D-dimmer when tourniquet was removed and on 3 hours after operation between two groups ( P >0. 05). At the end of 15 days after operation, the clinical manifestations including deep venous thrombosis in lower limb and pulmonary embolism in trial group were not observed,moreover, color Doppler ultrasound and CT examination showed no obvious abnormalities on 15 days after operation. Conclusion The application of tranexamic acid during TKA and short-term application after operation can decrease postoperative blood loss volume,with fafety,thus which is worthy of clinical reference.