Nemoto Akira, Mizuno Kana, Goyagi Toru
Department of Anaesthesia and Intensive Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.
Turk J Anaesthesiol Reanim. 2020 Apr;48(2):142-147. doi: 10.5152/TJAR.2019.08364. Epub 2019 Nov 25.
Tranexamic acid (TXA) has been used to reduce perioperative bleeding in various surgeries because of its antifibrinolytic effect. Recently, patients undergoing orthopaedic surgery in our institution received a loading dose of TXA (10 00 mg) before surgery, followed by 100 mg h until the end of surgery. The purpose of the present study was to evaluate the efficacy of TXA administration on the perioperative blood loss in patients undergoing knee arthroplasty or hip arthroplasty.
A retrospective cross-sectional study was conducted for the records in patients who underwent surgery without TXA administration (control group) and patients who underwent surgery with TXA administration (TXA group). Amount of intraoperative blood loss, intraoperative infusion volume, intraoperative blood transfusion volume, postoperative blood transfusion volume, changes in haemoglobin concentrations (ΔHb) and estimated blood loss were collected. Data were adjusted by propensity score method.
A total of 126 (63 in the control group and 63 in the TXA group) patients were included during the study period. Intraoperative infusion, postoperative transfusion, ΔHb and estimated blood loss were significantly reduced in the TXA group, although there were no significant differences in the volumes of intraoperative transfusion and blood loss.
The administration of TXA (loading dose of 1000 mg and continuous infusion of 100 mg h) reduced postoperative transfusion and perioperative blood loss. These results indicated that TXA administration is useful for reducing perioperative blood loss in patients undergoing knee or hip arthroplasty.
氨甲环酸(TXA)因其抗纤维蛋白溶解作用,已被用于减少各种手术中的围手术期出血。最近,在我们机构接受骨科手术的患者在手术前接受了一剂负荷量的TXA(1000mg),随后以100mg/h的速度持续给药直至手术结束。本研究的目的是评估TXA给药对接受膝关节置换术或髋关节置换术患者围手术期失血的疗效。
对未接受TXA给药的手术患者(对照组)和接受TXA给药的手术患者(TXA组)的记录进行回顾性横断面研究。收集术中失血量、术中输液量、术中输血量、术后输血量、血红蛋白浓度变化(ΔHb)和估计失血量。数据采用倾向评分法进行调整。
在研究期间共纳入126例患者(对照组63例,TXA组63例)。TXA组的术中输液量、术后输血量、ΔHb和估计失血量均显著减少,尽管术中输血量和失血量无显著差异。
TXA给药(负荷剂量1000mg,持续输注100mg/h)减少了术后输血量和围手术期失血量。这些结果表明,TXA给药有助于减少接受膝关节或髋关节置换术患者的围手术期失血量。