Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty Decreases the Rate of Post-operative Blood Transfusions in People with Hemophilia: A Retrospective Case-Control Study
Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty Decreases the Rate of Post-operative Blood Transfusions in People with Hemophilia: A Retrospective Case-Control Study
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DOI：
10.1007/s11420-019-09711-0
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发表时间：
2020-10-01
期刊：
影响因子：
2.5
通讯作者：
Gomez-Cardero, Primitivo
中科院分区：
文献类型：
--
作者：
Rodriguez-Merchan, E. Carlos;Encinas-Ullan, Carlos A.;Gomez-Cardero, Primitivo
无血友病患者的全膝关节置换术（TKA）后，采用标准化多模式失血预防方法（MBLPM）（包括关节内氨甲环酸（TXA）（MBLPM-TXA））降低了输血率。然而，该主题尚未在血友病患者中得到解决。问题/目的我们的目的是研究MBLPM-TXA是否可以预防接受全膝关节置换术的血友病A患者的失血，从而减少术后输血的需要。方法采用回顾性病例对照研究方法，对30例重度血友病A患者行全膝关节置换术（TKA），其中MBLPM-TXA组（n = 15），MBLPM-TXA组（n = 15），无MBLPM-TXA组（n = 15）。在所有病例中，术前血红蛋白水平均大于13 g/dL。结果MBLPM-TXA组输血率为0，而非MBLPM-TXA组有46.6%（7/15）的患者需要输血。结论本回顾性病例对照研究表明，在接受TKA的血友病A患者中使用MBLPM-TXA可有效降低输血率。我们建议使用它。
Background Blood transfusion rates after total knee arthroplasty (TKA) in patients without hemophilia have diminished with the use of a standardized multimodal blood loss prevention method (MBLPM) that includes intra-articular tranexamic acid (TXA) (MBLPM-TXA). However, the topic has not been addressed in people with hemophilia. Questions/Purposes Our aim was to investigate whether the MBLPM-TXA prevents blood loss in patients with hemophilia A who undergo TKA, thereby decreasing the need for post-operative blood transfusion. Methods This retrospective case-control comparative study involved 30 TKA patients who had a severe degree of hemophilia A without inhibitions: one group treated with the MBLPM-TXA (n = 15) and a second group treated without it (n = 15). In all cases, the pre-operative hemoglobin level was greater than 13 g/dL. Results The MBLPM-TXA group had a transfusion rate of zero, whereas 46.6% of the patients (seven of 15) in the non-MBLPM-TXA group needed transfusion. Conclusion This retrospective case-control study showed that the use of an MBLPM-TXA in patients with hemophilia A who underwent TKA was effective in reducing rates of transfusion. We recommend its use.