Mariani Pablo, Buttaro Martin A, Slullitel Pablo A, Comba Fernando M, Zanotti Gerardo, Ali Pablo, Piccaluga Francisco
Hip Surgery Centre "Sir John Charnley", Italian Hospital of Buenos Aires, Buenos Aires - Argentina.
Hip Int. 2018 Mar;28(2):194-199. doi: 10.1177/1120700018768655.
Hip revision surgery is associated with a high probability of the necessity for a blood transfusion. Different studies support the use of tranexamic acid (TXA) to decrease the rate of transfusions in primary hip surgery. Nevertheless, the use of this drug in hip revision surgery has not yet been widely accepted. The aim of our study was to establish the rate of blood transfusion with and without TXA in hip revision surgery.
We retrospectively studied 125 hip revision surgery patients operated on between 2011 and 2014. We divided our series into 2 groups: the TXA group with 61 patients (in which a 1000 mg dose of TXA was used before the skin incision and a second identical dose after skin closure) and a control group with 64 patients. We analysed the red blood cell (RBC) transfusion rates and their odds risk as well as the presence of collateral complications.
Average RBC transfusion was 2.7 units/patient (range 0-6) in the control group compared to 1.6 units/patient (range 0-6) in the TXA group. A 90.11% (odds ratio [OR] 0.098; confidence interval [CI] 0.02-0.04; p<0.0029) odds risk reduction for transfusion of at least 1 unit of erythrocyte blood cell was observed in the TXA group. Complications associated with the TXA were similar in both groups.
The benefits of TXA have been shown in elective hip replacement. In this study, TXA proved to be safe and efficacious in reducing the need for transfusions following revision total hip arthroplasty.
髋关节翻修手术极有可能需要输血。不同研究支持在初次髋关节手术中使用氨甲环酸（TXA）来降低输血率。然而，这种药物在髋关节翻修手术中的应用尚未被广泛接受。我们研究的目的是确定在髋关节翻修手术中使用和不使用TXA时的输血率。
我们回顾性研究了2011年至2014年间接受手术的125例髋关节翻修手术患者。我们将该系列分为两组：TXA组有61例患者（在皮肤切口前使用1000mg剂量的TXA，皮肤缝合后使用相同剂量的第二剂）和对照组有64例患者。我们分析了红细胞（RBC）输血率及其比值风险以及是否存在附带并发症。
对照组平均每位患者的RBC输血量为2.7单位（范围0 - 6），而TXA组为每位患者1.6单位（范围0 - 6）。在TXA组中，观察到至少输注1单位红细胞血液的比值风险降低了90.11%（比值比[OR]0.098；置信区间[CI]0.02 - 0.04；p<0.0029）。两组中与TXA相关的并发症相似。
TXA在择期髋关节置换术中已显示出益处。在本研究中，TXA在减少全髋关节翻修术后的输血需求方面被证明是安全有效的。
