Batıbay Sefa Giray, Türkmen İsmail, Duman Sedat, Çamur Savaş, Sağlam Necdet, Batıbay Sevilay
Department of Orthopedics and Traumatology, Health Sciences University Ümraniye and Training and Research Hospital, İstanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2018 Nov;24(6):575-580. doi: 10.5505/tjtes.2018.42147.
The aim of this study was to determine if the use of tranexamic acid (TXA) during intramedullary reaming treatment for tibial diaphyseal fractures was safe, reduced blood loss, or affected cost effectiveness.
A total of 70 patients with a tibia diaphysis fracture were randomized into 2 groups and prospectively followed for data on blood loss, thrombosis, and fracture healing. Preoperative TXA was administered intravenously to Group A, and Group B served as the control group.
While there was no significant difference between the preoperative and postoperative 1-hour hemoglobin (Hb) and hematocrit (Hct) levels of the patients, there was a statistically significant difference in the comparison of the postoperative 24-hour and 48-hour Hb and Hct levels. There was no need for an allogenic blood transfusion to any patient in Group A; however, 2 patients in Group B each received 1 unit of erythrocyte suspension because their Hct values dropped below 27%. There was no deep vein thrombosis or embolism observed in any of the patients.
The application of intravenous TXA during the preoperative period in the treatment of tibial fractures with intramedullary nailing reduced the bleeding seen in the postoperative period. It did not lead to intravascular thrombosis in the postoperative period, and had no adverse effect on bone healing.
本研究的目的是确定在胫骨干骨折髓内扩髓治疗期间使用氨甲环酸（TXA）是否安全、能减少失血或影响成本效益。
总共70例胫骨干骨折患者被随机分为2组，并对失血、血栓形成和骨折愈合数据进行前瞻性随访。A组患者术前静脉注射TXA，B组作为对照组。
患者术前和术后1小时血红蛋白（Hb）及血细胞比容（Hct）水平之间无显著差异，但术后24小时和48小时Hb及Hct水平比较存在统计学显著差异。A组没有患者需要异体输血；然而，B组有2例患者各接受了1单位红细胞悬液，因为他们的Hct值降至27%以下。所有患者均未观察到深静脉血栓形成或栓塞。
术前静脉注射TXA用于髓内钉固定治疗胫骨骨折可减少术后出血。术后未导致血管内血栓形成，且对骨愈合无不良影响。
