The Impact Of The Use Of Pneumatic Tourniquet And Tranexamic Acid On Perioperative Period Blood Loss In Primary Total Knee Arthroplasty

ObjectiveTo explore the impact of different use methods of tourniquet and different administration ways of tranexamic acid(TXA)in decreasing the volume of blood loss during the perioperative period for patients who underwent unilateral primary total knee arthroplasty(TKA).Methods120 patients who underwent TKA in our hospital from October 2016 to October 2018 were selected,and according to the method of random number table,they were randomly divided into two use groups.Pneumatic tourniquet was used in Group A from the beginning of operation to the stabilization of bone cement,while it was used in Group B from the beginning of osteotomy to the stabilization of bone cement.Then,the patients in both Group A and B were randomly divided into two TXA groups again.the 4 groups above are A1 group(29 patients),A2 group(31 patients),B1 group(28 patients)and B2 group(32 patients)respectively.The total of blood loss,intraoperative blood loss,postoperative obvious and hidden blood loss,rate of blood transfusion,and incidence of deep venous thrombosis(DVT)were compared among the four groups.ResultsAll patients were followed up for 4 months.There was no significant difference in basic admission data between the four groups(p > 0.05).The intraoperative blood loss of group A1 was(121.0 +33.5)ml,that of group A2 was(109.0 +34.9)ml,that of group B1 was(127.1 +36.3)ml,and that of group B2 was(130.0 +38.1)ml;There was no statistical significance among the four groups in the intraoperative blood loss(p >0.05).Group B2 was evidently better than the other groups in the postoperative obvious and hidden blood loss as well as the total of blood loss,and the differences were statistically significant(p <0.05);Group B1 was better than Group A1,Group B2 was better than Group A2,and the differences were statistically significant(p <0.05).Group A2 was better than Group A1,Group B2 was better than Group B1,and the differences were statistically significant(p <0.05).The rate of blood transfusion in Group B2 was lower than the other groups,and the differences were statistically significant(p <0.05);Symptomtic DVT and pulmonary embolism(PE)were not found postoperatively in all groups;No symptoms of wound infection were found in the four groups.ConclusionThe limited use of pneumatic tourniquet and the combined use of TXA in TKA can effectively reduce the perioperative blood loss and the rate of blood transfusion,and their combination does not increase DVT and PE risks.