Study On The Efficacy And Safety Of Tranexamic Acid With Different Administration Methods In Perioperative Hemostasis Of High Tibial Osteotomy

Objective:To investigate whether intravenous drip combined with local irrigation of tranexamic acid(TXA)during perioperative period of high tibial osteotomy(HTO)is superior to intravenous administration alone inperioperative blood loss,postoperative relief of swelling and pain,incision complications,thrombosis complications,postoperative recovery of knee function,etc.Methods:Sixty patients who met the inclusion criteria and needed HTO in the orthopaedic department of our hospital from September 2018 to January 2020 were selected and randomly divided into intravenous administration group(group A)and intravenous combined local administration group(group B),with 30 patients in each group.Conventional medial open wedge high tibial osteotomy was performed in both groups,and the same postoperative tube mode was adopted.In group A,1GTXA was intravenously dripping 10min before the upper tourniquet(TXA in this study was 100mL tranexamic acid saline injection containing 0.5gTXA),and A large amount of normal saline was repeatedly rinsed before the incision was closed intraoperatively.In group B,1.0G TXA was intravenously dripping 10min before the tourniquet,and the incision was rinsed with normal saline before the incision was closed intraoperatively,then the incision was rinsed with 1.0G TXA and soaked for 3 minutes.Comparing two groups of preoperative and postoperative 1d,3d,5d map of protein(Hb),red blood cells deposited lower value(HCT),blood transfusion rate,24h after knee joint pain score,48h after drainage pipe,drain swelling degree,3 days after the operation area of postoperative incision complications,postoperative thrombosis complications,knee functional score at 3 months.Results:In the perioperative period of HTO,intravenous administration combined with local rinsing of TXA is better than intravenous administration alone,which can reduce perioperative blood loss and postoperative drainage volume,reduce the degree of limb swelling and pain in the early postoperative period,without increasing the risk of thromboembolism complications.There was no effect on perioperative blood transfusion rate,incision complications and late knee function recovery.Therefore,the application of TXA in local flushing of middle vein in HTO may be of great value.