University of Health Sciences, Health Application and Research Center, Yüksek İhtisas Training and Research Hospital, Department of Orthopedics and Traumatology, Bursa, Turkey.
Ortop Traumatol Rehabil. 2020 Oct 31;22(5):339-346. doi: 10.5604/01.3001.0014.4224.
The aim of this study was to compare outcomes in patients who received intravenous tranexamic acid just before and after total knee arthroplasty with or without drains and to analyze whether there is any difference in terms of blood loss.
This is a retrospective analysis of prospectively collected data of patients undergoing unilateral total knee arthroplasty. Between March 2017 and March 2019, 97 knees of 94 consecutive patients with osteoarthritis were divided into two groups (Group 1, with drain; and 2, without drain). Drainage group (53 knees; average age, 66,1±7,0 years; male, 10; female, 43) and a drainless group (44 knees; average age, 63,7± 7,5 years; male, 4; female, 40). All patients received systemic tranexamic acid (in 100 mL saline infusion iv in 30 minutes prior to the tourniquet inflation and 3 hours after the operation). Blood loss, allogeneic blood transfusion rates, complications such as swelling of the cruris, infection (deep or superficial), thromboembolic incidents (Deep venous thrombosis or pulmoner thromboembolism) and length of hospital stay were assessed postoperatively.
There was no difference in demographic parameters, body mass index, side ofsurgery, ASA score and anesthesia type between 2 groups. The preoperative Hb levels were comparable but on the postoperative day one, Hb level was lower in the drain group (p=0,017). Total blood loss (TBL) and allogeneic transfusion rates were lower in the drainless group, although did not differ significantly between the two groups [TBL: 1360,9±502,5 / 646,1-2641,6 (1251,6) mL in the Group 1, 1205,6±505,0 / 396,6-2521,0 (1157,5) mL in Group 2 (p=0,134); Transfusion rates: 11 out of 53 cases (%20,8) in group 1 and 5 out of 44 cases (%11,4) in group 2]. The infection rate and length of hospital stay were lower in the drainless group. But there were no statistical difference was found in terms of complications and length of hospital stay between 2 groups.
本研究旨在比较膝关节置换术前和术后即刻接受静脉注射氨甲环酸的患者的治疗效果，并分析失血方面是否存在差异。
这是一项对前瞻性收集的单侧膝关节置换术患者数据进行的回顾性分析。2017 年 3 月至 2019 年 3 月，94 例骨关节炎患者的 97 例膝关节分为两组（1 组有引流管；2 组无引流管）。引流组（53 例膝关节；平均年龄 66.1±7.0 岁；男性 10 例；女性 43 例）和无引流组（44 例膝关节；平均年龄 63.7±7.5 岁；男性 4 例；女性 40 例）。所有患者均在止血带充气前 30 分钟内（在 100 毫升生理盐水中静脉输注氨甲环酸）和术后 3 小时内接受全身氨甲环酸治疗。术后评估失血量、异体输血率、小腿肿胀等并发症、感染（深部或浅部）、血栓栓塞事件（深静脉血栓形成或肺栓塞）和住院时间。
两组患者的人口统计学参数、体重指数、手术侧、ASA 评分和麻醉类型无差异。术前血红蛋白水平相当，但术后第 1 天，引流组的血红蛋白水平较低（p=0.017）。无引流组的总失血量（TBL）和异体输血率较低，但两组间差异无统计学意义[TBL：引流组 1360.9±502.5/646.1-2641.6（1251.6）毫升，无引流组 1205.6±505.0/396.6-2521.0（1157.5）毫升（p=0.134）；输血率：引流组 11/53 例（20.8%），无引流组 5/44 例（11.4%）]。无引流组的感染率和住院时间较短。但两组间并发症和住院时间无统计学差异。
