Comparison Of The Hemostatic Effect Of Primary Total Knee Arthroplasty In Intravenous And Intra-articular Injection Of Tranexamic Acid

Objective Comparison of effects of different ways of application of tranexamic acid on total knee arthroplasty(TKA).Methods Select 60 patients who met the inclusion criteria in January 2014-2015 in August, divided into 2 groups according to the random classification method, group A intravenous infusion(Before installation prosthesis 15 minutes by intravenous drip into 1g tranexamic acid) group(n = 30), and group B for injection(intra-articular injection 1g of tranexamic acid after skin suture) group(n = 30), And collect the patient’s sex, age, height, weight, preoperative hemoglobin(HB), hematocrit(HCT), coagulation, D-2 dimer index, intraoperative blood loss, blood volume(calculated by the anesthesiologist), drainage bottles when removing the lead flow, after the first three or six days also need to collect HB, HCT, coagulation, D-2 dimer indicators. Intraoperative blood loss by the dominant anesthetist blood loss and post-drainage bottles drainage record(group B are reduced by the amount of the drainage tube 100 ml TXA injected). Calculation hidden blood loss through CROSS equation, and to observe the incidence of thrombosisResult The total blood loss in group B(895.41 + 239.02) ml was lower than that in group A(1020.89 + 210.83) ml, and the difference was statistically significant(P<0.05). Intraoperative blood loss group B(118.17 ± 12.49) ml, group A(123.33 ± 11.01) ml, the difference was not statistically significant(P> 0.05), In the total postoperative drainage volume, the B group(294.33 + 54.25) ml was lower than that in the A group(373.33 + 48.02ml), and the difference was statistically significant(P<0.05). Postoperative recessive hemorrhage group B(529.39 ± 207.57) ml, A group(477.74 ± 226.92) ml, the difference was not statistically significant(P> 0.05). After the first,third and sixth day monitoring Fib, PT, APTT, D-2 polymer value, the difference was not statistically significant(P> 0.05). No blood transfusion, symptomatic deep venous thrombosis and fatal pulmonary embolism occurred in the two groups.Conclusion In the total knee arthroplasty to topical application of tranexamic acid on the hemostatic effect is better than that of intravenous.