Zhu Rangteng, Jiang Hantao, Xu Wei, Shen Liping, Jin Gang
Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
Front Surg. 2023 Feb 23;10:1052039. doi: 10.3389/fsurg.2023.1052039. eCollection 2023.
To evaluate the impact of intra-articular injection with tranexamic acid (TXA) on total blood loss (TBL) and postoperative pain after arthroscopic rotator cuff repair (ARCR).
This study retrospectively included patients with full-thickness rotator cuff tears who underwent shoulder ARCR surgery in Taizhou hospital, China, between January 2018 and December 2020. Patients received 10 ml (100 mg/ml) of intra-articular TXA injection (TXA group) or 10 ml of normal saline (non-TXA group) after the incision was sutured. The primary variable was the type of drug injected into the shoulder joint at the end of the operation. The primary outcome were perioperative TBL and postoperative pain [measured by visual analog scale (VAS)]. The secondary outcomes were differences in red blood cell count, hemoglobin count, hematocrit, platelet count.
A total of 162 patients were included, 83 patients in TXA group and 79 patients in non-TXA group. Notably, patients in TXA group were more likely to have lower TBL volume [261.21 (175.13-506.67) ml vs. 382.41 (236.11-593.31), = 0.025], and postoperative VAS score ≤ 2 within 24 h ( = 0.031) compared with those in non-TXA group. In addition, the median hemoglobin count difference was significantly lower in TXA group than that of in non-TXA group ( = 0.045), while, the differences in median counts of red blood cell, hematocrit, and platelet between the two groups were comparable (all > 0.05).
Intra-articular injection of TXA might reduce the TBL and degree of postoperative pain within 24 h after shoulder arthroscopy.
评估关节腔内注射氨甲环酸（TXA）对关节镜下肩袖修复术（ARCR）后总失血量（TBL）和术后疼痛的影响。
本研究回顾性纳入了2018年1月至2020年12月在中国台州医院接受肩关节ARCR手术的全层肩袖撕裂患者。切口缝合后，患者接受10毫升（100毫克/毫升）关节腔内TXA注射（TXA组）或10毫升生理盐水（非TXA组）。主要变量是手术结束时注入肩关节的药物类型。主要结局是围手术期TBL和术后疼痛[采用视觉模拟评分法（VAS）测量]。次要结局是红细胞计数、血红蛋白计数、血细胞比容、血小板计数的差异。
共纳入162例患者，TXA组83例，非TXA组79例。值得注意的是，与非TXA组相比，TXA组患者的TBL量更低[261.21（175.13 - 506.67）毫升 vs. 382.41（236.11 - 593.31），P = 0.025]，且术后24小时内VAS评分≤2分的比例更高（P = 0.031）。此外，TXA组血红蛋白计数的中位数差异显著低于非TXA组（P = 0.045），而两组红细胞、血细胞比容和血小板计数中位数的差异无统计学意义（均P > 0.05）。
关节腔内注射TXA可能会减少肩关节镜检查后24小时内的TBL和术后疼痛程度。
