Seviciu Alexandru, Gross Irwin, Fathima Samreen, Walsh Stephen M
Department of Anesthesia, Eastern Maine Medical Center, Bangor, ME, USA.
Transfusion Services, Eastern Maine Medical Center, Bangor, ME, USA.
Arthroplast Today. 2016 Mar 31;2(2):77-82. doi: 10.1016/j.artd.2015.12.007. eCollection 2016 Jun.
The purpose of this study was to compare 2 blood management interventions, tranexamic acid (TXA) and bipolar sealer system (BSS) used independently or in combination with a control group during primary total knee arthroplasty (TKA).
A total of 127 TKA patients were enrolled and randomized into 4 groups: Intravenous TXA plus the BSS (N = 29, group 1); TXA only (N = 29, group 2); BSS only (N = 31, group 3); and intravenous normal saline as a control group (N = 32, group 4).
Changes in hemoglobin from baseline to postoperative follow-up were significantly lower among patients who received TXA plus BSS and those receiving TXA only when compared with the control. BSS only did not differ significantly when compared to the control group. In addition, TXA plus BSS was as efficacious as TXA only in preserving postoperative hemoglobin.
In other terms, using bipolar sealer did not add to the effect of TXA in reducing the postoperative hemoglobin drop in primary TKA.
本研究的目的是比较两种血液管理干预措施，即氨甲环酸（TXA）和双极电凝系统（BSS），在初次全膝关节置换术（TKA）中单独使用或联合使用时与对照组的效果。
共纳入127例TKA患者，随机分为4组：静脉注射TXA联合BSS（N = 29，第1组）；仅使用TXA（N = 29，第2组）；仅使用BSS（N = 31，第3组）；静脉注射生理盐水作为对照组（N = 32，第4组）。
与对照组相比，接受TXA联合BSS以及仅接受TXA的患者从基线到术后随访时血红蛋白的变化显著更低。仅使用BSS与对照组相比无显著差异。此外，TXA联合BSS在保留术后血红蛋白方面与仅使用TXA效果相同。
换句话说，在初次TKA中，使用双极电凝器对TXA减少术后血红蛋白下降的效果没有额外作用。
