Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty.

Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty.
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DOI:
10.1016/j.arth.2013.06.011
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发表时间:
2013-10
影响因子:
3.5
通讯作者:
Waters, Jonathan H.
Waters, Jonathan H.
中科院分区:
医学2区
文献类型:
--
作者:
Konig, Gerhardt;Hamlin, Brian R.;Waters, Jonathan H.

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本研究的目的是确定局部应用氨甲环酸(TXA)是否能减少原发性全髋关节置换术(THA)和原发性全膝关节置换术(TKA)术后出血和输血率。同一位外科医生连续招募了290名患者。在全膝关节置换术中,在关节切开术关闭后向膝关节内注射TXA溶液。在全髋关节置换术中,关节在手术过程中的三个点浸泡在TXA溶液中。在THA和TKA中,TXA溶液的浓度为每100mL生理盐水3gm TXA。TKA组和THA组非txa患者的平均失血量均显著高于TKA组和THA组。TKA组和THA组的TXA术后输血显著减少,分别从10%降至0%,从15%降至1%。局部应用TXA可显著降低TKA和THA术后出血量和输血风险。
The objective of this study was to determine if tranexamic acid (TXA) applied topically reduced postoperative bleeding and transfusion rates after primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). Two hundred and ninety consecutive patients from a single surgeon were enrolled. In TKA, TXA solution was injected into the knee after closure of the arthrotomy. In THA, the joint was bathed in TXA solution at three points during the procedure. In both THA and TKA the TXA solution was at a concentration of 3gm TXA per 100mL saline. The mean blood loss was significantly higher in the non-TXA patients in both TKA and THA groups. Postoperative transfusions decreased dramatically with TXA, dropping from 10% to 0%, and from 15% to 1%, in the TKA and THA groups, respectively. Topical application of TXA significantly reduces postoperative blood loss and transfusion risk in TKA and THA.
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