To Observe The Effect Of Tranexamic Acid To Reduce Blood Loss After Knee Arthroplasty

Objective Tranexamic acid intravenous drip combined with local joint cavity injection to reduce the primary effect of osteoarthritis total knee arthroplasty(TKA)blood。Method First Affiliated Hospital of Xinxiang Medical College bone ward from March 2014 to August 2015 underwent total knee arthroplasty(TKA)and 60 cases of primary osteoarthritis were randomly divided into observation group and control group of 30 cases,In relax before tourniquet intravenous injection of tranexamic acid 10mg/kg;Experimental group: at the end of installation of prosthesis,sutures in the capsule after the drainage tube into the ammonia tranexamic acid solution 50ml(ammonia tranexamic acid 1g dissolved in physiological saline);The control group: in the installation of prosthesis end through the drainage tube,50 ml saline was injected into articular capsule after suture;Two groups were treated with drainage tube temporary clipping 1 h.The amount of bleeding were compared between the two groups,the hidden blood loss,total blood loss,postoperative drainage,postoperative 24 h hemoglobin level,blood transfusion and the occurrence of adverse reactions.14 days after the surgery limb deep venous ultrasonography has no deep venous thrombosis and to compare the two groups.Result 1、After operation,the total induced flow rate(160.3 + 87.1),hidden blood loss(338.1 + 245.3),total blood loss(542.2 + 186.2)were lower than that of control group(P<0.05),all of which had statistical significance;24h hemoglobin level(100.9 + 22.7)was higher than that of control group(P<0.05),which was statistically significant;The difference was not significant between the two groups(P>0.05).2、The difference was not significant(P>0.05)between the two groups of patients with hemoglobin,red cell pressure and D-two polymer;The difference of hemoglobin and red blood cell pressure in the two groups after operation was compared,(P<0.05),with statistical significance;3、The D-two(3.52 + 0.43)and(3.76 + 0.54)L / Mg in the 24 h experimental group and the control group were significantly higher than those before the operation(0.27 + 0.12)and(0.28 + 0.13)L / Mg,the difference was statistically significant(P<0.05);After the operation,the average value of the two groups of D-two was compared with that of the control group,which was higher than the experimental group,but there was no significant difference(P>0.05).4、There were no blood transfusion in the experimental group and 4 cases in the control group.The difference of the number of blood transfusion and blood transfusion in the two groups was statistically significant(P< 0.05).Two groups of patients had no wound infection,thrombosis and pulmonary embolism,etc.complications.During the course of treatment does not appear related adverse effects of tranexamic acid.Conclusion 1、 Intravenous infusion combined with intra-articular injection of tranexamic acid solution can effectively reduce the TKA postoperative blood loss.2 、combined application of tranexamic acid reduced intravenous application,reduce the blood transfusion and the formation of deep venous thromboembolism(VTE),pulmonary embolism(PE)and other risks.