Temporary clamping of drain combined with tranexamic acid reduce blood loss after total knee arthroplasty: a prospective randomized controlled trial.
Temporary clamping of drain combined with tranexamic acid reduce blood loss after total knee arthroplasty: a prospective randomized controlled trial.
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DOI：
10.1186/1471-2474-13-124
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发表时间：
2012-07-20
影响因子：
2.3
通讯作者：
Pornrattanamaneewong C
中科院分区：
文献类型：
--
作者：
Chareancholvanich K;Siriwattanasakul P;Narkbunnam R;Pornrattanamaneewong C
全膝关节置换术(TKA)与大量失血有关。据报道，有几种方法可以减少术后失血量，避免异体输血。在这项研究中，我们研究了临时阻断引流管或不联合氨甲环酸给药控制TKA术后出血的有效性。这项前瞻性、随机、双盲研究在我所进行。共240例确诊为原发性骨关节炎并计划接受初次全膝关节置换术的患者被随机分为四组：A组或对照组，不夹管，患者接受安慰剂；B组，不夹管，患者接受氨甲环酸；C组，管夹，患者接受安慰剂；D组，管夹住患者，患者接受氨甲环酸。记录并比较两组患者术后48h引流量、术后12h血红蛋白(Hb)下降情况及需输血例数。3个研究组(B、C、D组)术后平均引流量和输血量均明显低于对照组(p <； 0.0 5)，D组最低。B组和D组维持Hb水平优于A组和C组(p <； 0.001)。在输血率方面，D组输血量虽少于A组和C组(p <； 0.0 5)，但D组与B组比较差异无统计学意义(P>0.0 5)。与D组相比，A组、B组和C组需要输血的相对危险度分别为4.4、1.4和3.0。ClinicalTrials.gov NCT01449552
Total knee arthroplasty (TKA) is associated with a significant blood loss. Several methods have been reported to reduce postoperative blood loss and avoid homologous blood transfusions. In this study, we investigated the efficacy of temporary clamping of the drain either or not in combination with tranexamic acid administration for controlling blood loss after TKA. The prospective, randomized, and double-blinded study was conducted in our institute. Total of 240 patients, who diagnosed primary osteoarthritis and scheduled to undergo a primary TKA,,were randomized into one of the four groups: Group A or control group, the drain was not clamped and the patient received a placebo; Group B, the drain was not clamped and the patient received tranexamic acid; Group C, the drain was clamped and the patient received a placebo; and Group D, the drain was clamped and the patient received tranexamic acid. The volume of drained blood at 48 hours postoperatively, the decreasing of hemoglobin (Hb) level at 12 hours postoperatively and the number of patients requiring blood transfusion were recorded and compared. The mean postoperative volumes of drained blood and the amount of blood transfusion in the three study groups (group B, C and D) were significantly lower than those in the control group (p < 0.05), which group D had the lowest values. Furthermore, group B and D could maintain the Hb level better than group A and C (p < 0.001). In terms of blood transfusions rate, although the patients in group D required transfusion less than group A and C (p < 0.05), there was no significant difference between group D and B. The relative risks for transfusion requirement were 4.4 for group A, 1.4 for group B and 3.0 for group C when compared to group D. The clamping of drain combined with tranexamic acid administration could reduce postoperative blood loss and blood transfusion after TKA, significantly greater than using tranexamic acid or drain clamping alone. ClinicalTrials.gov NCT01449552
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DOI：
10.2106/00004623-199274050-00003
发表时间：
1992-06-01
影响因子：
5.3
作者：
CLEMENTS, DH;SCULCO, TP;LEVINE, DB
通讯作者：
LEVINE, DB
影响因子：
6.5
作者：
DUBBER, AHC;MCNICOL, GP;DOUGLAS, AS
通讯作者：
DOUGLAS, AS
影响因子：
168.9
作者：
KLENERMAN, L;CHAKRABARTI, R;STIRLING, Y
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STIRLING, Y
DOI：
10.1302/0301-620x.78b3.0780434
发表时间：
1996-05-01
影响因子：
--
作者：
Benoni, G;Fredin, H
通讯作者：
Fredin, H
影响因子：
2.7
作者：
Gibbons, CER;Solan, MC;Patterson, M
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Patterson, M