Department of Orthopaedics, West China Hospital of Sichuan University, No.37 of Guoxue lane, Wuhou District, Chengdu, 610041, Sichuan, China.
Department of Orthopaedics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Sci Rep. 2022 Jun 9;12(1):9542. doi: 10.1038/s41598-022-13861-3.
Only a few of studies have reported whether Tranexamic acid (TXA) has the same benefits during total ankle replacement as hip and knee replacements. In our study, we hypothesized that TXA was effective in reducing the perioperative blood loss without increasing the risk of symptomatic venous thromboembolism of patients during total ankle replacement. We retrospectively reviewed 71 patients who underwent total ankle replacement at the foot and ankle surgery center of our institution between January 2017 and May 2021. Patients were divided into two groups according to whether they received intravenous tranexamic acid or not. Patients who received intravenous TXA showed significantly lower estimated intraoperative blood loss, hidden blood loss and total blood loss. The early AOFAS score and ROM at the first month follow up of TXA group were better than the NO-TXA group and the incidence of early wound infection and poor healing (< 1 month postoperative) was significant lower than NO-TXA group. Use of TXA was not associated with significant changes in the incidence of postoperative symptomatic venous thromboembolism. We conclude that intravenous TXA can safely and effectively reduce perioperative blood loss and the incidence of early wound infection and poor healing in total ankle replacement, without increasing the risk of symptomatic venous thromboembolism.The application of TXA following total ankle replacement helped improve ankle function and patient quality of life during the early stage.
仅有少数研究报告了氨甲环酸（TXA）在全踝关节置换中是否与髋关节和膝关节置换具有相同的益处。在我们的研究中，我们假设 TXA 可有效减少全踝关节置换围手术期的失血，而不会增加患者发生症状性静脉血栓栓塞的风险。我们回顾性分析了 2017 年 1 月至 2021 年 5 月在我院足踝外科中心接受全踝关节置换的 71 例患者。根据是否接受静脉注射氨甲环酸，将患者分为两组。接受静脉注射 TXA 的患者术中估计出血量、隐性失血量和总失血量显著减少。TXA 组术后第 1 个月的 AOFAS 评分和 ROM 优于 NO-TXA 组，早期伤口感染和愈合不良（<1 个月）的发生率显著低于 NO-TXA 组。TXA 的使用与术后症状性静脉血栓栓塞的发生率无显著变化相关。我们的结论是，静脉注射 TXA 可安全有效地减少全踝关节置换围手术期的失血以及早期伤口感染和愈合不良的发生率，而不会增加症状性静脉血栓栓塞的风险。全踝关节置换术后应用 TXA 有助于改善踝关节功能和患者的生活质量。
