Eachempati K K, Gurava Reddy A V, Apsingi S, Sankineani S R, Shaheed J, Dannana C
Maxcure Hospital, Behind Cyber Towers, Madhapur, Hyderabad, 500081, India.
Department of Orthopaedics, Sunshine Hospital, Penderghast Road, Secunderabad, 500003, India.
Musculoskelet Surg. 2017 Dec;101(3):255-259. doi: 10.1007/s12306-017-0477-9. Epub 2017 May 3.
Blood loss in total knee arthroplasty (TKA) is an area of significant concern as it has an effect on patient morbidity and hospital stay. Among many different modalities to reduce blood loss, the use of Tranexamic acid has become a standard procedure nowadays. The aim of our study was to determine if Tranexamic acid alone decreases blood loss as an independent variable irrespective of other blood loss preserving measures.
This prospective non-randomized study included patients undergoing unilateral TKA by conventional method (Group 1) and computer-assisted TKA (Group 2). All the patients in both groups received Tranexamic acid in a dose of 10 mg/kg body weight prior to inflation of tourniquet. Blood loss in both the groups was calculated using Nadler's formula, and haemoglobin (Hb) level was calculated on day one and day three after surgery.
The mean drop of Hb in Group 1 was 1.608 and 1.56 g/dl in Group 2 which was statistically significant (p < 0.001); however, none of the patients in either of the groups actually required any blood transfusion postoperatively. Although there was a significant drop in haemoglobin and haematocrit in both the groups, on comparison, there was no significant difference in blood loss and fall in Hb levels between the groups (p > 0.001).
Tranexamic acid decreases blood loss in patients undergoing TKA independent of all the other blood conserving procedures.
全膝关节置换术(TKA)中的失血是一个备受关注的领域,因为它会影响患者的发病率和住院时间。在众多减少失血的不同方法中,氨甲环酸的使用如今已成为标准程序。我们研究的目的是确定单独使用氨甲环酸作为一个独立变量是否能减少失血,而不考虑其他保血措施。
这项前瞻性非随机研究纳入了通过传统方法进行单侧TKA的患者(第1组)和计算机辅助TKA的患者(第2组)。两组所有患者在止血带充气前均接受10mg/kg体重剂量的氨甲环酸。两组的失血量均使用纳德勒公式计算,术后第1天和第3天计算血红蛋白(Hb)水平。
第1组Hb的平均下降值为1.608,第2组为1.56g/dl,具有统计学意义(p<0.001);然而,两组中实际上没有患者术后需要输血。虽然两组的血红蛋白和血细胞比容均有显著下降,但相比之下,两组之间的失血量和Hb水平下降没有显著差异(p>0.001)。
氨甲环酸可减少接受TKA患者的失血,且独立于所有其他保血程序。