Akgül Turgut, Büget Mehmet, Salduz Ahmet, Edipoğlu İpek S, Ekinci Mehmet, Küçükay Süleyman, Şen Cengiz
İstanbul University, Istanbul Faculty of Medicine, Department of Orthopaedics and Traumatology, Turkey.
İstanbul University, Istanbul Faculty of Medicine, Department of Anaesthesiology, Turkey.
Acta Orthop Traumatol Turc. 2016 Aug;50(4):429-31. doi: 10.1016/j.aott.2016.06.007. Epub 2016 Jul 16.
The aim of this study was to analyse the effectiveness of single dose of 20 mg/kg intravenous tranexamic acid (TXA), in reducing the blood loss in patients undergoing total knee arthroplasty (TKA).
70 patients (65.5 ± 8.1 years old) that have undergone TKA were divided in two groups. The 20 mg/kg IV TXA was given before the skin incision to one group (study group). On the control group, TKA was performed without TXA. The demographic data, body mass index, amount of bleeding and erythrocyte infusion during the operation, hemoglobin and hematocrit values (preoperative and 48th hour), the amount of drainage after the operation were compared between the groups.
The total amount of bleeding in the study group was 634.03 ± 182.88 ml and 1166.42 ± 295.92 ml in the control group (p < 0.001). Perioperative bleeding was 252.01 ± 144.13 ml in the study group and 431.33 ± 209.10 ml in the control group (p = 0.018). The drainage after the operation was 311.11 ± 141.64 ml at the 24th hour in the study group, 640.74 ± 279.43 ml at the 24th hour in the control group (p < 0.001). The drainage after 24th hour was 97.96 ± 115.86 ml in the study group and 112.96 ± 64.43 ml in the control group (p = 0.584).
A high, single dose of TXA intravenously given to the patient prior to the TKA significantly reduces the bleeding during the operation and within the postoperative 24 h. There is no significant change in the bleeding amount after the 24th hour following the operation.
本研究旨在分析单剂量20mg/kg静脉注射氨甲环酸(TXA)对全膝关节置换术(TKA)患者减少失血的有效性。
70例行TKA的患者(65.5±8.1岁)被分为两组。一组(研究组)在皮肤切开前给予20mg/kg静脉注射TXA。对照组行TKA时未使用TXA。比较两组患者的人口统计学数据、体重指数、术中出血量及红细胞输注量、血红蛋白和血细胞比容值(术前和术后48小时)、术后引流量。
研究组总出血量为634.03±182.88ml,对照组为1166.42±295.92ml(p<0.001)。研究组围手术期出血量为252.01±144.13ml,对照组为431.33±209.10ml(p=0.018)。研究组术后24小时引流量为311.11±141.64ml,对照组为640.74±279.43ml(p<0.001)。研究组术后24小时后引流量为97.96±115.86ml,对照组为112.96±64.43ml(p=0.584)。
TKA术前给患者静脉注射高剂量单剂量TXA可显著减少术中及术后24小时内的出血。术后24小时后出血量无显著变化。