Comparison of perioperative blood loss and transfusion rate in primary unilateral total hip arthroplasty by topical, intravenous application or combined application of tranexamic acid
Zhao Qing-bin
Ren Jiang-dong
Zhang Xiao-gang
Wu Hu-zi?Wu Lamu
Abstract：BACKGROUND: The tranexamic acid has been widely used in hip arthroplasty. Studies have confirmed that the safety and efficacy of tranexamic acid when it is used in topical or intravenous application, but the effects are not clear when it is used in both topical and intravenous application. OBJECTIVE: To compare perioperative blood loss and transfusion rate in primary unilateral total hip arthroplasty with topical, intravenous and both injection of tranexamic acid. METHODS: 136 patients undergoing primary unilateral total hip arthroplasty in the First Affiliated Hospital, Xinjiang Medical University between July 2014 and June 2015 were divided into three groups. Topical group:a total of 1 g tranexamic acid was given in the articular cavity of 44 cases. Intravenous group: 1 g tranexamic acid was immersed in 250 mL physiological saline, and given 10 minutes before operation in 44 cases. Combined group: 1 g tranexamic acid was intravenously given before operation, and then given in the articular cavity in 48 cases. Total blood loss, transfusion rate, the maximum hemoglobin decrease, the maximum hematocrit decrease, and incidence of deep vein thrombosis were compared among the three groups. RESULTS AND CONCLUSION: Total blood loss, the maximum hemoglobin decrease and the maximum hematocrit decrease were significantly lower in the combined group than in the topical group and intravenous group (P < 0.01). No significant difference in total blood loss, the maximum hemoglobin decrease and the maximum hematocrit decrease was detected between the topical group and intravenous group (P > 0.05). Doppler ultrasound examination of lower limb blood vessel at 5 days and 1 month after surgery in 136 patients did not demonstrate deep vein thrombosis. None of them suffered from pulmonary embolism. These findings confirm that intravenous and topical application of tranexamic acid could obviously reduce blood loss in patients with total hip arthroplasty. Curative effect and safety were superior to intravenous or topical application alone. No significant difference in transfusion rate was detected among the three methods.
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Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 459-464 )