Clinical Study Of The Application Of Tranexamic Acid In Total Hip Arthroplasty

Objective To compare different application methods of the tranexamic acid(TXA)in the treatment of primary total hip arthroplasty(THA)and evaluate the efficacy and safety of patients with blood loss(both dominant blood loss and hidden blood loss).Methods 75 cases of patients from November 2015 to November 2016 in the Zhongshan affiliated hospital of Dalian university in the treatment of total hip replacement,including 31 cases of male,44 cases of female,average age 61.0 ±5.5(50-71 years old),all patients who meet the inclusion criteria,and sign preoperative informed consent and cooperate with clinical research.75 patients were randomly divided into A,B,C,group of four patients in each group(n = 25).Group A: 1g tranexamic acid was given intravenously 30 minutes before surgery intravenous.Group B: 30 minutes before surgery 1g tranexamic acid was given intravenously and1 g tranexamic acid was given during operation.Group C: 30 minutes before surgery1 g tranexamic acid was given intravenously + 1g tranexamic acid was given during operation+ 1g tranexamic acid was given intravenously 3 hours after surgery.We recorded the amount of hemoglobin,postoperative drainage and preoperative and postoperative bleeding(HGB)and hematocrit(HCT),meanwhile examined lower extremity deep venous color Doppler ultrasound both preoperatively and postoperatively,observing whether the deep venous thrombosis of lower extremity(DVT)were formed.SPSS17.0 software were used for statistical analysis of the results.Results Group A: Dominant blood loss was(748.6±80.2)ml,hidden blood loss was(273.7±85.0)ml;group B: Dominant blood loss was(514.4±67.6)ml,hidden blood loss was(193.1±71.0)ml;group C: Dominant blood loss was(463.3±67.6)ml,hidden blood loss(168.2±75.0)ml.Three different method way of ammonia tranexamic acidgroup applied in B,C gruop were sharply decreased compare with group A,indicating dominant blood loss and hidden blood loss was both dropped in the treatment of primary total hip arthroplasty(P<0.05),the difference was statistically significant;but between group B and C,the dominant blood loss and hidden blood loss had no significant difference(P>0.05).And according to the application of ammonia method in all three groups,tranexamic acid,lower extremity deep venous thrombosis and pulmonary embolism was not seen in all patients,indicating this drug is safe and effective.Conclusion Compare with group A,both group B and C can significantly reduce perioperative blood loss in the primary total hip arthroplasty,and does not cause deep venous thrombosis and pulmonary embolism,these treatments are safe and effective role;but B and C comparison has no statistically significant,so 1g tranexamic acid given intravenously 30 minutes before surgery plus 1g tranexamic acid given during operation is recommended in the application of ammonia tranexamic acid for total hip replacement.