The analysis on perioperative blood loss factors and effect of tranexamic acid on the amount of occult bleeding in total knee arthroplasty
10.3760/cma.j.cn115455-20201106-01528
- VernacularTitle:膝关节置换术围手术期失血因素与氨甲环酸对隐性出血量的影响分析
- Author:
Wei PING
1
;
Wei WANG
;
Wei SONG
;
Panhong LI
;
Xiaojuan LIU
Author Information
1. 河北省定州市人民医院骨科 073000
- Keywords:
Kneejoint;
Arthroplasty, replacement, Hip;
Tranexamic acid;
Blood loss factor;
Occult bleeding
- From:
Chinese Journal of Postgraduates of Medicine
2021;44(12):1128-1132
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the factors of perioperative blood loss during total knee arthroplasty (TKA), and to analyze the influence of tranexamic acid on the amount of occult bleeding.Methods:A total of 100 patients who underwent TKA surgery in the knee surgery department of Dingzhou People′s Hospital from August 2018 to August 2020 were selected as the research subjects. According to whether tranexamic acid was used or not, they were divided into tranexamic acid group (68 cases) and non-tranexamic acid group (32 cases). The influence of the age, presence or absence of comorbidities, tourniquet use time, body mass index (BMI), platelet count (PLT) levels, and tranexamic acid use on TKA perioperative occult blood loss were analyzed.Results:Univariate analysis showed that factors such as age, presence or absence of comorbidities, tourniquet use time, BMI and PLT levels had a significant effect on occult blood loss, and the difference between different groups was statistically significant ( P<0.05), while gender and disease type, operation side, operation time and blood transfusion type had no significant effect on occult blood loss ( P>0.05); The latent blood loss in the tranexamic acid group was significantly lower than that in the non-tranexamic acid group: (662.47 ± 65.82) ml vs. (733.86 ± 59.86) ml, P<0.05. The proportion of allogeneic blood transfusion in the tranexamic acid group was significantly lower than that in the non-tranexamic acid group: 45.49%(31/68) vs. 68.75% (22/32), P<0.05. Postoperative drainage volume and perioperative total blood loss in the tranexamic acid group were significantly lower than those in the non-tranexamic acid group: (211.54 ± 85.63) ml vs. (427.61 ± 103.08) ml, (995.38 ± 187.11) ml vs. (1 276.42 ± 236.84) ml, P<0.05. Multivariate analysis showed that age, comorbidities, and tourniquet use time, and BMI were independent risk factors affecting the increase of perioperative occult blood loss ( P<0.05), and tranexamic acid was a protective factor ( P<0.05). Conclusions:Old age, comorbidities, excessive use time of tourniquets, and obesity can all cause the increase of perioperative occult blood loss during TKA. The use of tranexamic acid can effectively reduce the occult blood loss.
