Wassilew G I, Perka C, Janz V, Krämer M, Renner L
Charité, Universitätsmedizin Berlin, Rahel-Hirsch-Weg 5, Station 201a, 10117 Berlin, Germany.
Bone Joint J. 2015 Dec;97-B(12):1604-7. doi: 10.1302/0301-620X.97B12.35797.
We have investigated the effect of using tranexamic acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative blood loss and blood transfusion requirements. In addition we analysed whether the use of TXA was associated with an increased risk of venous thromboembolism (VTE) following this procedure. A consecutive series of 96 PAOs, performed by a single surgeon, were reviewed. A total of 48 patients received TXA and 48 did not. The TXA group received a continuous infusion of TXA at a rate of 10 mg/kg/h. The primary outcome measure was the requirement for blood transfusion. Secondary outcomes included total blood loss, the decrease in the level of haemoglobin in the blood, the length of hospital stay, and the complications of this treatment. The mean rate of transfusion was significantly lower in the TXA group (62.5% vs 12.5%, p < 0.001). The mean blood loss was also significantly reduced in the TXA group (1.9 L (standard deviation (SD) 0.9) vs 1.5 L (SD 0.7), p < 0.01). No post-operative episodes of VTE were identified in either group. The use of TXA reduced the blood loss and the rate of transfusion after PAO significantly, without adverse effects such as an increased rate of VTE.
我们研究了在髋臼周围截骨术（PAO）期间使用氨甲环酸（TXA）对围手术期失血和输血需求的影响。此外，我们分析了在此手术后使用TXA是否与静脉血栓栓塞（VTE）风险增加相关。回顾了由一位外科医生连续进行的96例PAO手术。共有48例患者接受了TXA治疗，48例未接受。TXA组以10mg/kg/h的速率持续输注TXA。主要结局指标是输血需求。次要结局包括总失血量、血液中血红蛋白水平的下降、住院时间以及该治疗的并发症。TXA组的平均输血率显著较低（62.5%对12.5%，p<0.001）。TXA组的平均失血量也显著减少（1.9L（标准差（SD）0.9）对1.5L（SD 0.7），p<0.01）。两组均未发现术后VTE发作。使用TXA可显著减少PAO后的失血量和输血率，且无VTE发生率增加等不良影响。
