Efficacy of oral tranexamic acid on blood loss in primary total hip arthroplasty using a direct anterior approach: a prospective randomized controlled trial
Efficacy of oral tranexamic acid on blood loss in primary total hip arthroplasty using a direct anterior approach: a prospective randomized controlled trial
复制标题
DOI：
10.1007/s00264-018-3846-6
复制
发表时间：
2018-11-01
影响因子：
2.7
通讯作者：
Kang, PengDe
中科院分区：
文献类型：
--
作者：
Zhao, HaiYan;Xiang, MaoYing;Kang, PengDe
背景：经静脉或局部给药的氨甲环酸（TXA）已被证明可减少初次标准全髋关节置换术（THA）患者的失血量、输血需求和相关医疗费用。口服TXA是否同样如此尚不清楚，本研究的目的是确定口服氨甲环酸在经直接前路行THA的患者中是否等同于静脉注射TXA。方法在本前瞻性随机对照试验中，120例经直接前路行原发性全髋关节置换术的患者被随机分为口服（2次剂量20mg/kg）、静脉注射（2次剂量15mg/kg）和不服用TXA组。主要结局是血红蛋白下降、红细胞压积水平、总失血量、术中失血量、输血需求和输液量。次要结局包括血栓栓塞事件、伤口并发症、术后住院时间和30天再入院。结果三组患者人口学特征相似（p < 0.05, n=40 /组）。口服组和静脉注射组的血红蛋白下降、红细胞压积水平、总出血量和术中出血量相似（p < 0.05），且显著小于对照组（p < 0.05）
BackgroundTranexamic acid (TXA), delivered intravenously or topically, has been shown to reduce blood loss, the need for transfusion, and relevant healthcare costs when administered in primary standard total hip arthroplasty (THA). Whether the same is true of oral TXA is unclear, the purpose of this study was to determine if oral tranexamic acid is equivalent to intravenous TXA in the case of patients undergoing THA via the direct anterior approach.MethodsIn this prospective randomized controlled trial, 120 patients undergoing primary THA by the direct anterior approach were randomized to receive oral TXA (two doses of 20mg/kg), intravenous TXA (two doses of 15mg/kg), or no TXA. Primary outcomes were haemoglobin drop, haematocrit levels, total blood loss, intra-operative blood loss, need for transfusion, and volume transfused. Secondary outcomes included thromboembolic events, wound complications, the length of post-operative hospital stay, and 30-day readmission.ResultsDemographic characteristics were similar among the three patient groups (p>0.05, n=40 per group). Haemoglobin drop, haematocrit levels, total blood loss, and intra-operative blood loss were similar in the oral and intravenous groups (p>0.05), and significantly smaller than in the control group (p