Aydın Bahattin Kerem, Durgut Fatih, Erkoçak Ömer Faruk, Acar Mehmet Ali
Department of Orthopedics and Traumatology, Medical Faculty of Selçuk University, 42100 Selçuklu, Konya, Turkey.
Eklem Hastalik Cerrahisi. 2017 Apr;28(1):25-9. doi: 10.5606/ehc.2017.52725.
This study aims to evaluate the effect of intra-articular tranexamic acid (TA) administration on the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and the total cost in total knee arthroplasty (TKA) patients.
The study included a total of 118 patients (24 males, 94 females; mean age 67.0 years, range 52 to 81 years) who underwent primary unilateral TKA surgery. Patients were divided into two groups as 58 patients who were performed intra-articular injection of 2 g TA after closure of articular capsule (TA group; 10 males, 48 females, mean age 65.6 years; range 55 to 80 years) and 60 patients who were not performed any intra-articular injection (non-TA group; 14 males, 46 females; mean age 68.3 years; range 52 to 81 years). The maximum difference between pre- and postoperative hemoglobin levels, the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and cost of each patient were recorded.
The mean difference between pre- and postoperative hemoglobin levels were higher in the non-TA group (1.7 g/dL vs 2.6 g/dL, p<0.05). The mean amounts of blood in drains (327.5 mL vs 800.0 mL, p<0.05), the amounts of blood transfusions (0 units vs 10 units, p<0.05), the mean lengths of hospital stay (4.03 days vs 4.53 days, p<0.05), and the hospital costs (1,935.26 United States dollars vs 1,959.64 United States dollars, p<0.05) were lower in TA group.
Administration of intra-articular TA during primary TKA may reduce blood loss and the need for blood transfusion while significantly shortening the postoperative length of hospital stay and reducing the total hospital costs.
本研究旨在评估关节腔内注射氨甲环酸（TA）对全膝关节置换术（TKA）患者引流管出血量、输血量、住院时间及总费用的影响。
本研究共纳入118例行初次单侧TKA手术的患者（24例男性，94例女性；平均年龄67.0岁，范围52至81岁）。患者分为两组，58例患者在关节囊闭合后行关节腔内注射2g TA（TA组；10例男性，48例女性，平均年龄65.6岁；范围55至80岁），60例患者未行任何关节腔内注射（非TA组；14例男性，46例女性；平均年龄68.3岁；范围52至81岁）。记录每位患者术前和术后血红蛋白水平的最大差值、引流管出血量、输血量、住院时间及费用。
非TA组术前和术后血红蛋白水平的平均差值更高（1.7g/dL对2.6g/dL，p<0.05）。TA组引流管平均出血量（327.5mL对800.0mL，p<0.05）、输血量（0单位对10单位，p<0.05）、平均住院时间（4.03天对4.53天，p<0.05）及住院费用（1935.26美元对1959.64美元，p<0.05）更低。
初次TKA术中关节腔内注射TA可减少失血及输血需求，同时显著缩短术后住院时间并降低总住院费用。
