University of Louisville School of Medicine, Louisville, KY.
Department of Orthopaedic Surgery University of Louisville, Jewish Hospital/KentuckyOne Health, Louisville, KY.
J Arthroplasty. 2014 Aug;29(8):1528-31. doi: 10.1016/j.arth.2014.03.011. Epub 2014 Mar 21.
The purpose of this study was to compare the efficacy of topical Tranexamic Acid (TXA) versus Intravenous (IV) Tranexamic Acid for reduction of blood loss following primary total knee arthroplasty (TKA). This prospective randomized study involved 89 patients comparing topical administration of 2.0g TXA, versus IV administration of 10mg/kg. There were no differences between the two groups with regard to patient demographics or perioperative function. The primary outcome measure, perioperative change in hemoglobin level, showed a decrease of 3.06 ± 1.02 in the IV group and 3.42 ± 1.07 in the topical group (P = 0.108). There were no statistical differences between the groups in preoperative hemoglobin level, lowest postoperative hemoglobin level, or total drain output. One patient in the topical group required blood transfusion (P = 0.342). Based on our study, topical Tranexamic Acid has similar efficacy to IV Tranexamic Acid for TKA patients.
本研究旨在比较局部应用氨甲环酸（TXA）与静脉内（IV）注射氨甲环酸在初次全膝关节置换术（TKA）后减少失血的效果。这项前瞻性随机研究涉及 89 例患者，比较了局部给予 2.0g TXA 与 IV 给予 10mg/kg TXA 的效果。两组患者在人口统计学或围手术期功能方面没有差异。主要观察指标为血红蛋白水平的围手术期变化，IV 组下降 3.06±1.02，局部组下降 3.42±1.07（P=0.108）。两组患者在术前血红蛋白水平、最低术后血红蛋白水平或总引流量方面均无统计学差异。局部组中有 1 例患者需要输血（P=0.342）。根据我们的研究，局部应用氨甲环酸与 IV 注射氨甲环酸在 TKA 患者中的疗效相似。
