Effects of tranexamic acid on recessive blood loss after closed reduction and intramedullary fixation in elderly patients with femoral intertrochanteric fracture

doi:10.3969/j.issn.1002-7386.2018.08.015

Abstract：Objective To investigate the effects of tranexamic acid on recessive blood loss after closed reduction and intramedullary fixation in elderly patients with femoral intertrochanteric fracture.Methods A total of 70 elderly patients with femoral intertrochanteric fracture who were admitted and treated in our hospital from June 2013 to June 2015 were divided into observation group (n =35) and control group (n =35). The patients in both groups were treated by femur rotor closed reduction and intramedullary nail fixation,and the patients in control group were not given tranexamic acid before surgery,who were given 0.9% sodium chloride solution 100ml by intravenous drip,however,the patients in observation group were given tranexamic acid mixed with 0.9% sodium chloride solution 100ml at one hour before surgery by intravenous drip.Then the operation time,red cell loss amount (total loss amount of red blood cell,loss amount of dominant red blood cell and loss amount of recessive red blood cell),postoperative transfusion volume and related indexes were observed and compared between two groups. Moreover the patients in both groups were examined by Doppler colour in lower limbs at 1 week after operation to find whether they had lower extremity deep vein thrombosis.Results There was no significant difference in operation time between two groups(P>0.05),however there were significant differences in total loss amount of red blood cell,loss amount of dominant red blood cell and loss amount of recessive red blood between two groups (P <0.05). There was no significant difference in incidence rate of venous thrombosis between two groups (P>0.05). Moreover the length of staying in hospital and hospitalization expense in observation group were significantly lower than those in control group (P <0.05),and the scores of all the indexes in observation group were superior to those in control group (P <0.05). In addition no adverse reactions,intraoperative infection,bone nonunion, osteomyelitis,vein thrombosis complications were observed in both groups, there were no significant differences in adverse reactions between two groups (P>0.05).Conclusion The application of tranexamic acid at one hour before surgery in closed reduction and intramedullary fixation in treatment of femoral intertrochanteric fracture can reduce the total loss amount of red blood cell and postoperative dominant and recessive red blood cell loss amount,thus,which is worth further clinical research.