Intra-articular injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in cementless total knee arthroplasty.
Intra-articular injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in cementless total knee arthroplasty.
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DOI：
10.1186/1749-799x-7-32
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发表时间：
2012-09-29
影响因子：
2.6
通讯作者：
Ikeda K
中科院分区：
文献类型：
--
作者：
Mutsuzaki H;Ikeda K
接受非骨水泥全膝关节置换术(TKA)的患者有时会失血过多。在一项回顾性研究中，我们探讨了术后关节内逆行注射氨甲环酸(TA)并保留引流钳1 h是否减少了失血量。将140例保留后十字韧带的单侧非骨水泥型人工全膝关节置换术患者分为两组：术后关节腔内注射TA(1000 mg)并夹闭引流管1 h(研究组，n = 70)和未给予TA且不夹闭引流管(对照组，n = 70)。记录术后总出血量、引流量、血红蛋白水平、输血量及输血率、术后第7天D-二聚体水平及并发症。研究组的总失血量、总引流量、平均输血量和输血率均低于对照组(P <； 0.001)。两组患者第1和第14天的血红蛋白水平相似，但第7天时，研究组的血红蛋白水平高于对照组(P <； 0.001)。D-二聚体水平在第7天研究组低于对照组(P <； 0.05)。两组均未出现并发症。术后即刻关节腔内逆行注射TA，1 h夹闭引流管，有效地减少了非骨水泥型全膝关节置换术后的出血量和输血量。我们认为，这种方法简单易行，适合这些患者。
Patients undergoing cementless total knee arthroplasty (TKA) sometimes suffer large blood loss. In a retrospective study, we explored whether postoperative intra-articular retrograde injection of tranexamic acid (TA) and leaving a drain clamp in place for 1 h reduced blood loss. Patients (n = 140) treated with unilateral primary cementless TKA (posterior cruciate ligament retained) were divided into two groups: those who had an intra-articular injection of TA (1000 mg) and drain clamping for 1 h postoperatively (study group, n = 70) and those who were not given TA and did not undergo clamping of their drains (control group, n = 70). Postoperative total blood loss, volume of drainage, hemoglobin level, transfusion amounts and rates, D-dimer level at postoperative day (POD) 7, and complications were recorded. Total blood loss, total drainage, mean transfusion volume, and transfusion rates were lower in the study group than in controls (P < 0.001). Hemoglobin levels on PODs 1 and 14 were similar in the groups, but on POD 7 the hemoglobin level was higher in the study group than in controls (P < 0.001). D-dimer level on POD 7 was lower in the study group than in controls (P < 0.05). There were no complications in either group. Immediately postoperative intra-articular retrograde injection of TA and 1 h of drain-clamping effectively reduced blood loss and blood transfusion after cementless TKA. We believe that this method is simple, easy, and suitable for these patients.