Atalay İsmail Burak, Yapar Aliekber, Ulucakoy Coskun, Duman Emek Mert, Toğral Güray, Ozturk Recep, Güngör Bedii Şafak
Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, TUR.
Orthopedics, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, TUR.
Cureus. 2020 Aug 29;12(8):e10105. doi: 10.7759/cureus.10105.
The aim of this study is to evaluate the risk of thromboembolic events and amount of postoperative blood loss and transfusion in patients who received preoperative tranexamic acid (TXA) administration in proximal femoral resection and endoprosthesis of proximal femur malignant lesion.
In this study, the data of 46 patients who underwent extensive resection and proximal femoral tumor prosthesis for proximal femoral bone malignancies were retrospectively reviewed. Patients were divided into two groups according to preoperative 15 mg/kg bolus intravenous administration of TXA. These patients were compared in terms of postoperative blood loss, postoperative bleeding, and transfusion requirements.
There were 46 patients (18 female, 28 male) with a mean age of 60.7±14.7 (19-89) years. Fifteen patients (32.6%) were treated with iv TXA. In the TXA group (46.7%), there was a statistically significant decrease in the need for transfusion compared to the patient group (93.5%) without TXA (p=0.001). Postoperative 24th hour, 48th hour,and total drainage blood loss values were found to be significantly lower in the TXA group (p=0.047, p=0.015, and p=0.019, respectively). There was no thromboembolic event observed.
Because of proximal femoral malignancy, extensive tumor resection and preoperative bolus 15 mg/kg TXA administration in proximal femoral prosthesis surgery significantly decreased the amount of postoperative bleeding and transfusion requirement without increasing the risk of thromboembolic event.
Level III - retrospective comparative study.
本研究旨在评估接受术前氨甲环酸（TXA）治疗的股骨近端恶性病变切除及股骨近端假体植入患者的血栓栓塞事件风险、术后失血量及输血量。
本研究回顾性分析了46例行股骨近端骨恶性肿瘤广泛切除及股骨近端肿瘤假体植入术患者的数据。根据术前静脉推注15mg/kg TXA将患者分为两组。比较两组患者的术后失血量、术后出血情况及输血需求。
46例患者（18例女性，28例男性），平均年龄60.7±14.7（19 - 89）岁。15例患者（32.6%）接受静脉TXA治疗。与未接受TXA治疗的患者组（93.5%）相比，TXA组（46.7%）输血需求有统计学显著降低（p = 0.001）。TXA组术后第24小时、第48小时及总引流量失血值均显著更低（分别为p = 0.047、p = 0.015和p = 0.019）。未观察到血栓栓塞事件。
对于股骨近端恶性肿瘤，在股骨近端假体手术中进行广泛肿瘤切除并术前静脉推注15mg/kg TXA可显著减少术后出血量及输血需求，且不增加血栓栓塞事件风险。
Ⅲ级 - 回顾性对比研究。
