DiBlasi Joseph F, Smith Ross P, Garavaglia Jeffrey, Quedado Jeffrey, Frye Benjamin M, Dietz Matthew J
Department of Orthopaedics, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, Morgantown, West Virginia.
Am J Orthop (Belle Mead NJ). 2016 Nov/Dec;45(7):E439-E443.
We conducted a study to compare the cost, efficacy, and safety of intravenous (IV) tranexamic acid (TXA) and topical TXA in primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). We retrospectively reviewed the cases of 291 patients who received either IV TXA or topical TXA before and after surgery. Significant differences favored topical TXA in reducing the postoperative decrease in hemoglobin levels in THA (P = .031) and TKA (P = .015) and calculated blood loss in TKA (P = .019). The groups did not differ in transfusion requirements for either THA or TKA. Topical TXA cost significantly more than IV TXA (P ≤ .0001). The benefits of using topical TXA to reduce the perioperative decrease in hemoglobin levels come with increased cost.
我们进行了一项研究，以比较静脉注射氨甲环酸（TXA）和局部应用TXA在初次全髋关节置换术（THA）和全膝关节置换术（TKA）中的成本、疗效和安全性。我们回顾性分析了291例在手术前后接受静脉注射TXA或局部应用TXA的患者病例。在THA（P = 0.031）和TKA（P = 0.015）中，局部应用TXA在减少术后血红蛋白水平下降方面有显著优势，在TKA中计算得出的失血量方面也有显著优势（P = 0.019）。THA或TKA的输血需求在两组之间没有差异。局部应用TXA的成本显著高于静脉注射TXA（P≤0.0001）。使用局部应用TXA来减少围手术期血红蛋白水平下降的益处伴随着成本的增加。
