Majumdar Pradyumna K, Goyal Goutam, Kumar Virender, Potalia Rajsingh, Roy Sirshendu, Punia Piyush
Department of Orthopaedics, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
J Orthop Case Rep. 2025 Jun;15(6):287-293. doi: 10.13107/jocr.2025.v15.i06.5740.
Intertrochanteric (IT) fracture surgeries make up a significant portion of trauma operations worldwide. The routine use of tranexamic acid (TXA) for these surgeries is not common in current practice at most places. This prospective study evaluated its efficacy in reducing perioperative blood loss and accentuating its potential for a better outcome.
A total of 100 patients were divided equally into two groups, A and B. Group A was given preoperative intravenous (IV) TXA and intraoperative topical TXA through the drain, while Group B was given preoperative and intraoperative normal saline. Both groups were comparable in age, body mass index, preoperative hemoglobin (Hb), surgery performed, and duration of surgery.
The mean drain volume, postoperative Hb, fall of Hb, and total blood loss were all significantly less in Group A as compared to Group B (P < 0.01). None of the patients in either group received more than one unit of blood transfusion. No complications were seen in any of the patients till the final follow-up.
In comparison to other studies, our study is in agreement that TXA overall helps in blood conservation; however, our study is unique in the way that the combination of preoperative IV and intraoperative topical TXA has resulted in the best possible results.
转子间骨折手术在全球创伤手术中占很大比例。目前大多数地方在这些手术中常规使用氨甲环酸并不常见。这项前瞻性研究评估了其在减少围手术期失血方面的疗效,并突出了其改善预后的潜力。
总共100例患者被平均分为A、B两组。A组术前静脉注射氨甲环酸,并通过引流管术中局部使用氨甲环酸,而B组术前和术中使用生理盐水。两组在年龄、体重指数、术前血红蛋白(Hb)、所进行的手术及手术时长方面具有可比性。
与B组相比,A组的平均引流量、术后血红蛋白、血红蛋白下降及总失血量均显著减少(P < 0.01)。两组均无患者接受超过一个单位的输血。直至最终随访,所有患者均未出现并发症。
与其他研究相比,我们的研究一致认为氨甲环酸总体上有助于节约用血;然而,我们的研究独特之处在于术前静脉注射与术中局部使用氨甲环酸的联合使用取得了最佳效果。