Tranexamic Acid Combined With Epinephrine Recovery For Blood Loss And Knee Function Of Total Knee Arthroplasty

Objective:To investigate the effects of intravenous infusion of tranexamic acid(TXA)combined with epinephrine(EPI)on total unilateral artificial knee arthroplasty(TKA)The effect of early functional recovery of joints.Methods:A total of 122 patients with unilateral TKA treated with orthopedic treatment were randomly divided into TXA + EPI group(n = 31):intravenous infusion(N = 30):intraarticular injection of epinephrine group;control group(n = 30)):Blank control group.TXA + EPI group was given intravenous infusion of tranexamic acid(10 mg/kg)10 min before the operation of the tourniquet,and 50 ml(1:200000)of adrenaline dilution was injected into the joint cavity before the end of the suture capsule.(10mg/kg),and the rats in the EPI group were given adrenaline dilution into the joint cavity before the end of the suture joint capsule.Liquid 50ml(1:200000),after injection of the drainage tube 2h;control group only after tracheal drainage tube 2h,intravenous infusion of tranexamic acid and intraarticular injection of adrenaline.The incidence of total blood loss,postoperative drainage,occult blood loss,postoperative blood transfusion rate,24hD-dimer level,postoperative deep vein thrombosis(DVT),postoperative 3～5d on the patellar and patellar 10cm circumference average changes in the value of the first 1,3,5 d after knee activity(rang of motion ROM),7 days after the knee HSS score,followed up for 3 months,clear whether the occurrence Deep vein thrombosis.Results:Four patients in the TXA + EPI group had an incisional healing and extended to 3 weeks.The remaining three groups of patients were wound healing,2 weeks or so stitches,no incision skin necrosis,no pulmonary embolism.1.There were no significant differences in the preoperative hematopoietic hematocrit,preoperative hematocrit,preoperative knee joint activity and preoperative HSS score(P>0.05).There was no significant difference between the two groups(P>0.05)No deep venous thrombosis was found after 7 days.Followed up in March,no symptoms of deep venous thrombosis.2.The TXA + EPI group,TXA group and EPI group were significantly lower than those in the control group(P<0.05),while the TXA + EPI group compared with the TXA group,the TXA group,the TXA group,the TXA group,The total blood loss,postoperative drainage and recessive blood loss were significantly decreased in EPI group(P<0.05).Compared with EPI group,TXA group had no significant difference(P>0.05)in TXA group compared with EPI group(P>0.05),but there was significant difference between TXA group and TXA group(P<0.05)(P>0.05).TXA + EPI group,TXA group and EPI group were significantly lower than those in control group(P<0.05),but there was no significant difference between TXA group and TXA group Rate,but there was no significant difference between the three groups of patients.There was no significant difference between the D-dimer and the D-dimer in the four groups,but the control group and the EPI group were more obvious than the combined group and the TXA group.3.TXA+EPI group were significantly lower than those in TXA group,EPI group and control group(P<0.05).The TXA group and EPI group were significantly higher than those in control group(P<0.05)(P<0.05).The mean change of TXA group was higher than that of EPI group at 3～5 days after 3～5 days of patellar and patellar circumference There was no significant difference(P>0.05).4.TXA + EPI group was significantly higher than that in TXA group,EPI group and control group at 7 days after operation(rang of motion ROM),and the HSS score of knee group was significantly higher than that of control group(P<0.05).TXA group and EPI group were significantly higher than those in the control group at 1,3 and 5 days postoperatively(rang of motion ROM)and HSS score at 7 days after operation(P<0.05).Compared with EPI group There was no significant difference in knee Hss score at 7 days after operation(rang of motion ROM)at 1,3 and 5 days postoperatively(P>0.05).Conclusion:1.ntravenous infusion of methotrexate combined with intraarticular injection of adrenaline significantly reduced the amount of blood loss after primary unilateral TKA surgery,and the reduction of recessive blood loss was more obvious,thereby reducing the postoperative blood transfusion rate,but did not increase postoperative The risk of deep venous thrombosis;2.ntravenous infusion of methotrexate combined with intraarticular injection of epinephrine significantly reduced the early knee swelling,increased knee activity,effectively improve the early postoperative knee function,improve the rapid recovery of the knee,There is a certain application value,but may cause delayed wound healing and other complications,clinical application need to be cautious.