| Degenerative osteoarthritis of the knee is a common disease in the elderly people,pain and dysfunction seriously affect the quality of the-ir lives,it has become the main cause of disability in the aged.Total Knee Arthroplasty(TKA)is the most effective method for the end stage of the knee osteoarthritis.With the coming of aging society,so the number of patients who choose to undergo knee arthroplasty will incr-ease rapidly.Although the present TKA technique is mature,but the e-lderly usually coexist some internal diseases,such as anemia、malnutri-tion,cardio cerebrovascular disease,these will increase the risks of pe-rioperative TKA surgery,especially the amount of blood loss volume,resulting in blood transfusion will be brought blood-borne infections,bl-ood transfusion reaction,circulation overload such as risk,Multiple blows will further affect postoperative functional recovery of the patient.As a fibrinolytic hemostatic drugs,tranexamic acid has used increain-g gradually,although in gynecology、obstetrics、dental and cardiac sur gery were proved to be an economic and effective ways to reduce blo-od loss volume,but applied to the total knee arthroplasty,orthopedic surgeons have some concerns about it,such as increase the incidence of lower extremity deep vein thrombosis and pulmonary embolism.Ho-wever,the optimal prescription and dosage are still controversial,and there is no uniform standard.Objective:To investigate the effects of different Tranexamic acid application on postoperative blood loss volume and safety during Total Keen Arthr oplasty.Methods:Clinical data were received from the patients by primary TKA in our department from September 2017 to September 2019.They were d-ivided into three groups according to the application of TXA.Group A(Not used TXA).Group B(TXA was combined with 20mg/kg intra-venous infusion,and 2g TXA was applide into joint);Group C(B+ T XA 1g used by intravenous at postoperation 3 hours);The general data of the three groups were recorded and compared,including total blood loss,drainage volume,transfusion rate,postoperative hospital stay,D-dimer,3-day postoperative suprapatellar diameter increment,incidence of venous thrombosis in the lower extremity,and postoperative compl ications.Results:A total of 122 eligible patients were included.The average total blood loss of patients in group A,B and C during the perioperative p-eriod were 1026± 297 m L,733± 292 ml,and 726± 234 m L,and the average drainage capacity of A,B,and C at 24 h after operation was 675± 245 m L,410± 235 m L,and 371± 284 m L,and the average postoperative hospitalization was 13.51± 3.5d,9.25± 2.0d,9.15± 2.1d,there was a si-gnificant statistical difference between group A and group B and grou-p C(P <0.001),but there was no significant difference between group B and group C(P>0.05).There were no significant differences in the results of D-dimer,the incidence of deep vein thrombosis of the lowe-r limbs,and the diameter increase of 5cm around the knee in the three groups(P>0.05).Conclusion:Topical application TXA combined with venous administration can s-ignificantly reduce blood loss and drainage volume,reduce transfusion rate and hospital stay,and do not increase the incidence of venous thrombosis in lower extremities,but no significant difference was found between the latter two groups. |
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