A Clinical Comparative Study On The Placement Or Non Placement Of Drainage Tube After The Combination Of Intravenous Tranexamic Acid And Total Hip Arthroplasty

Objective:To explore whether the drainage tube should be placed after the intravenous drip of tranexamic acid in total hip replacement.Methods:A retrospective analysis was made on 132 patients who received the first unilateral total hip arthroplasty and received intravenous injection of tranexamic acid during the operation.According to whether the drainage tube was placed after the operation,the patients were divided into drainage group(62 cases)and non drainage group(70 cases).Four kinds of indexes were compared between the two groups:(1)blood related indexes:postoperative blood loss,postoperative blood transfusion rate,postoperative blood transfusion amount and postoperative hemoglobin value;(2)postoperative complications:deep vein thrombosis of the lower extremity,incision complications such as bloodinfiltration,infection,swelling and ecchymosis;(3)average hospital stay;(4)functional evaluation: Harris evaluation of hip joint at the first,third and sixth months after follow-up Points.The experiment was approved by the ethics committee of the second hospital of Shanxi Medical University.Results:There was no significant difference in blood loss(438.88 ± 124.46 ml vs 400.46± 120.34 ml,P > 0.05),blood transfusion rate(9 / 62 vs 6 / 70),blood transfusion volume(248.23 ± 124.43 ml vs 210.31 ± 120.95 ml,P > 0.05)and hemoglobin value(102.33 ± 3.27 ml vs 101.82 ± 3.34 ml,P > 0.05)between drainage group and non drainage group.Evaluation of postoperative complications: there was no difference in the incidence of DVT between the drainage group and the non drainage group(4 cases vs 2cases,P > 0.05),while the incidence of incision complications was higher than that of the non drainage group(8 cases vs 2 cases,P < 0.05).The average hospitalization time of drainage group was longer than that of non drainage group(9.66 ± 1.36 days vs 7.29± 1.55 days,P < 0.05).There was no significant difference in Harris score of hip joint between the two groups(P > 0.05).Conclusion:Under the guidance of eras concept,after intravenous drip of tranexamic acid during total hip replacement,combined with fine operation during operation,hemostasis is seriously,and drainage tube placement is unnecessary.No drainage device has no effect on blood loss and blood transfusion,can significantly shorten the average hospital stay and reduce the incidence of incision complications,and does not affect the early rehabilitation and hip function of patients.No drainage after total hip replacement is safe and effective.