Clinical Study On The Effect Of Different Medications Of Tranexamic Acid In Hemostatic Effect Of Artificial Knee Arthroplasty

Aim: In this study,prospective clinical comparative experimental design was used to compare tranexamic acid in the venous and local joint cavity during unilateral artificial knee arthroplasty.The blood loss,blood transfusion rate,early pain degree,lower extremity venous thrombosis.The effects of formation and early functional scoring to study the hemostatic effect and safety of tranexamic acid in knee replacement.Methods: A total of 108 patients who underwent unilateral TKA surgery in the Department of Bone and Joint Surgery,Chengyang District People's Hospital,Qingdao,from December 2016 to December 2017 were enrolled.A total of 108 patients were eligible for inclusion in this study.They were randomly divided into groups A,B and C.Group A was intravenously administered with tranexamic acid in a total of 34 cases.In the 30 minutes before the loose tourniquet,a 100 ml rapid intravenous drip of sodium chloride injection containing 1g of tranexamic acid was given.Note: Group B was a topical application of tranexamic acid group,a total of 38 cases,after closing the knee joint incision,100 ml of sodium chloride injection containing 1g of tranexamic acid was injected into the joint cavity.Group C was a blank control group,a total of 36 cases.After closing the knee joint incision,100 ml of simple sodium chloride injection was injected into the joint cavity.The total blood loss of the patients was calculated postoperatively.The number of patients with allogeneic blood transfusion was recorded.The pain score was recorded 24 hours after operation.The lower extremity vascular B-ultrasound was performed on the 7th day after surgery to detect the presence of deep vein thrombosis.The KSS score of the affected knee at 6 weeks after follow-up was used to comprehensively evaluate the hemostatic efficacy and safety of tranexamic acid in TKA.Result: The total blood loss of group A patients was(958.52±296.83)ml,the total blood loss of group B patients was(1089.78±369.08)ml,the total blood loss of group C was(1374.57±479.13)ml;the VAS pain score 24 hours after operation,group A was4.71±1.494,group B was 4.71±1.073,group C was 7.15±0.790;Joint KSS score at 6weeks after operation,84.59±4.21 in group A,83.55±3.92 in group B,and 78.39±4.20 in group C;B-ultrasound examination of the three groups of patients in the past 7 days showed no deep vein thrombosis of the lower extremities.Conclusion: 1.In unilateral total knee arthroplasty,intravenous and local intra-articular injection of tranexamic acid has a significant effect on reducing bleeding and reducing blood transfusion rate,and the effect of intravenous application is better(P<0.05).2.Intravenous and topical application of tranexamic acid can reduce the degree of pain in the knee joint in the early postoperative period.3.The application of tranexamic acid has positive significance for the early rehabilitation of knee function in patients.4.Intravenous knee arthroplasty,regardless of intravenous or topical use of tranexamic acid,did not increase the risk of deep vein thrombosis of the lower extremities.