A study on the effectiveness and safety of tranexamic acid to reduce blood loss during the perioperative period of total hip arthroplasty
WANG Hao-yang
KANG Peng-de
PEI Fu-xing
YANG Jing
SHEN Bin
ZHOU Zong-ke
MA Jun
HUANG Qiang
SHI Xiao-jun
Abstract：Objective To investigate the effectiveness and safety of tranexamic acid ( TXA ) to reduce blood loss during the perioperative period in patients who underwent primary unilateral total hip arthroplasty ( THA ). Methods Sixty patients scheduled to undergo primary unilateral THA were randomized into the TXA group (n=30 ) and the control group (n=30 ). All the patients had blood routine examination, coagulation routine examination and color Doppler lfow imaging of the lower limbs. The patients in the TXA group were given 10 mg / kg TXA by intravenous administration at 10 minutes before the surgery and those in the control group were given normal saline of the same dose instead. The intraoperative blood loss and postoperative drainage volume were recorded. The blood routine reexamination was conducted at 1 and 3 days after the operation, and the hemoglobin level and hematocrit were recorded. The color Doppler lfow imaging of the lower limbs was performed again 5 days after the operation. The patient would be given 2 units of red cell suspension if the haemoglobin was lower than 80 g / L. The equation was used to calculate and compare the blood volume and visible and hidden blood loss. The incidences of postoperative blood transfusion and deep vein thrombosis were recorded.Results In the TXA group, the intraoperative blood loss, postoperative drainage volume and visible and hidden blood loss were less than that in the control group, and the differences were statistically signiifcant. Blood transfusion was needed in 1 patient ( 3.3%, 1 / 30 ) in the TXA group and 8 patients in the control group ( 26.7%, 8 / 30 ), and the differences were statistically significant. Calf muscular venous thrombosis was found in 1 patient in the TXA group, and no lower limb deep venous thrombosis was observed in the control group. The differences in the incidence of deep venous thrombosis and the length of postoperative hospital stay between the 2 groups were not statistically signiifcant.Conclusions The blood loss during the perioperative period can be signiifcantly reduced and the risk of deep vein thrombosis and pulmonary embolism will not be increased, with a single intravenous administration of 10 mg / kg TXA before THA. This method is safe and effective to control the blood loss during the perioperative period of THA.
Keywords：Tranexamic acidArthroplastyreplacementhipPerioperative periodBlood losssurgicalPostoperative hemorrhage
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 649-654 )