Efficacy and safety of tranexamic acid on reducing blood loss in bilateral total knee arthroplasty
10.3969/j.issn.2095-4344.2015.22.002
- VernacularTitle:氨甲环酸减少双侧全膝关节置换失血量的有效性及安全性评价
- Author:
Rong WANG
;
Shaoqi TIAN
;
Chengzhi HA
;
Ruixue SONG
;
Kang SUN
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2015;(22):3451-3456
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:The blood loss and the need of blood transfusion after bilateral total knee arthroplasty are very high. Therefore, the use of medicine such as tranexamic acid in total knee arthroplasty is overheated in recent years. Tranexamic acid has been proved to be able to decrease the blood loss after total knee arthroplasty, while the study of its use in bilateral total knee arthroplasty is seldom. OBJECTIVE:To observe the effect and safety of tranexamic acid on perioperative blood loss and the change of hemoglobin in patients undergoing bilateral total knee arthroplasty. METHODS: We selected 69 patients who received bilateral total knee arthroplasty and divided them into two different groups randomly. The patients in the experimental group were given 1 g of tranexamie acid dissolved in 100 mL of 5% glucose solution through intravenous infusion. Those in control group were only given 5% glucose solution 100 mL. Total blood loss, intraoperative blood loss, the hidden blood loss, amount of postoperative drainage, the ratio of blood transfusion, hemoglobin, D-dimer, prothrombin time and activated partial thromboplastin time were studied and compared between the two groups. We also observed the incidence of thrombotic events between the two groups. RESULTS AND CONCLUSION:The blood loss of the experimental group was significantly lower compared to the control group (t=2.194-2.908,P < 0.05). The blood transfusion rate of experimental group was significantly lower compared to the control group (χ2=5.219,P=0.022). The hemoglobin of the experimental group was significantly higher than that of the control group at 3 and 5 days after replacement (t=-3.481, 2.319,P < 0.05). No significant difference in prothrombin time and activated partial thromboplastin time was detectable between the two groups before and after replacement (P > 0.05). Thrombotic events were not visible in both groups. Venous ultrasonography in the lower extremity did not reveal deep venous thrombosis. Above results suggest that tranexamic acid can significantly reduce intraoperative blood loss in patients undergoing bilateral total knee arthroplasty, decreases the requirement of blood transfusion and the dynamic change of hemoglobin, and does not increase the risk of thrombosis.
