Lei Jinlai, Zhang Binfei, Cong Yuxuan, Zhuang Yan, Wei Xing, Fu Yahui, Wei Wei, Wang Pengfei, Wen Shiming, Huang Hai, Wang Hu, Han Shuang, Liu Shuguang, Zhang Kun
Department of Orthopaedic Trauma, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, No 555, Youyi East Road, Xi'an, Shaanxi Province, China.
J Orthop Surg Res. 2017 Aug 15;12(1):124. doi: 10.1186/s13018-017-0625-9.
Hidden blood loss is a major concern for patients undergoing hip surgery for intertrochanteric fracture. The objective of this study was to investigate whether tranexamic acid (TXA) could reduce postoperative hidden blood loss in patients undergoing hip surgery for intertrochanteric fracture.
A total of 77 patients with intertrochanteric fracture were enrolled in this randomized controlled study. Patients received either 200 mL (1 g) of TXA (n = 37) or normal-saline (NS) (n = 40) i.v. before hip surgery using proximal femoral nail anti-rotation (PFNA). Hemoglobin and hematocrit levels were measured preoperatively and postoperatively at day 1 and 3. Visible and hidden blood loss volumes were calculated at postoperative day 3.
On postoperative day 3, the transfusion rate was significantly lower in the TXA group compared to the NS group, although mean hemoglobin and hematocrit levels were not significantly different between the two groups. However, the estimated hidden blood loss volume (210.09 ± 202.14 mL vs. 359.35 ± 290.12 mL; P < 0.05) and total blood loss volume (279.35 ± 209.11 mL vs. 417.89 ± 289.56 mL; P < 0.05) were significantly less in the TXA group compared to the NS group, respectively.
TXA significantly reduced postoperative hidden blood loss in patients with intertrochanteric fracture who underwent PFNA. (Registration number: ChiCTR-INR-16008134).
隐性失血是转子间骨折行髋关节手术患者的主要关注点。本研究的目的是探讨氨甲环酸（TXA）是否能减少转子间骨折行髋关节手术患者的术后隐性失血。
本随机对照研究共纳入77例转子间骨折患者。患者在使用股骨近端防旋髓内钉（PFNA）进行髋关节手术前，静脉注射200 mL（1 g）TXA（n = 37）或生理盐水（NS）（n = 40）。术前及术后第1天和第3天测量血红蛋白和血细胞比容水平。术后第3天计算显性和隐性失血量。
术后第3天，TXA组的输血率显著低于NS组，尽管两组的平均血红蛋白和血细胞比容水平无显著差异。然而，TXA组的估计隐性失血量（210.09±202.14 mL对359.35±290.12 mL；P<0.05）和总失血量（279.35±209.11 mL对417.89±289.56 mL；P<0.05）分别显著低于NS组。
TXA显著减少了接受PFNA治疗的转子间骨折患者的术后隐性失血。（注册号：ChiCTR-INR-16008134）
