Piolanti Nicola, Del Chiaro Andrea, Matassi Fabrizio, Graceffa Angelo, Nistri Lorenzo, Marcucci Massimiliani
1st Orthopaedic Department, University of Pisa, Via Paradisa 2, 56100, Pisa, Italy.
Department of Surgical Science and Translational Medicine, University of Florence, Largo P. Palagi 1, 50139, Florence, Italy.
Eur J Orthop Surg Traumatol. 2018 Feb;28(2):233-237. doi: 10.1007/s00590-017-2038-1. Epub 2017 Sep 8.
The use of tranexamic acid (TXA) in total hip arthroplasty (THA) can significantly reduce blood losses with many clinical and economical advantages. However, no consensus has been reached regarding the optimal regimen for TXA administration. The aim of this study is to analyse and compare the haemostatic effect of two different intravenous (IV) regimens of TXA.
We planned a single-centre, prospective, randomized study including 80 patients who underwent primary unilateral minimally invasive THA because of a hip osteoarthritic degeneration. We divided patients into two groups: the G10 group received two IV doses of 10 mg/kg of TXA, and the G20 group received two doses of 20 mg/kg.
No significant differences in mean minimum levels of Hb and HcT stratified by days after surgery were uncovered between the two groups despite the use of two different dosages of TXA. Also the mean blood volume loss was statistically similar between two groups. No differences were also observed regarding the occurrence of adverse effects.
In two IV bolus regimens of TXA administration, the use of a dose of 10 or 20 mg/kg provides statistically similar results in blood loss sparing. Therefore, the use of two 10 mg/kg doses could be considered more advisable in order to reduce the potential thromboembolic risks related to this drug.
在全髋关节置换术(THA)中使用氨甲环酸(TXA)可显著减少失血,具有诸多临床和经济优势。然而,关于TXA给药的最佳方案尚未达成共识。本研究的目的是分析和比较两种不同静脉注射(IV)方案的TXA的止血效果。
我们计划进行一项单中心、前瞻性、随机研究,纳入80例因髋骨关节炎退变接受初次单侧微创THA的患者。我们将患者分为两组:G10组接受两次静脉注射剂量为10mg/kg的TXA,G20组接受两次剂量为20mg/kg的TXA。
尽管使用了两种不同剂量的TXA,但两组术后各天分层的平均最低血红蛋白(Hb)水平和血细胞比容(HcT)水平均无显著差异。两组的平均失血量在统计学上也相似。在不良反应的发生方面也未观察到差异。
在两种TXA静脉推注方案中,10mg/kg或20mg/kg剂量在减少失血方面的统计学结果相似。因此,为降低与该药物相关的潜在血栓栓塞风险,使用两次10mg/kg剂量可能更可取。