Effect Of Tranexamic Acid On Hemorrhage In Elderly Patients Undergoing Hemiarthroplasty

objective:A retrospective study of the effect of tranexamic acid(TXA)in elderly patients with femoral neck fractures in hip joint replacement surgery on hemoglobin(Hb)loss(especially hemoglobin loss)and blood transfusion rate Evaluation provides some reference and help for clinical work.Methods:We conducted a retrospective cohort study of all hip replacement patients who had undergone a femoral neck fracture in our hospital between July 1,2015 and July 1,2017,and compared their use before skin incision.Patients with tranexamic acid had influence on hemoglobin level,postoperative hemoglobin Hb loss(especially hemoglobin loss),and transfusion rate.In our hospital from July 1,2015 to July 1,2017,a total of 115 hip joint replacements were performed.According to the use of tranexamic acid,there was no tranexamic acid group(TXA),and no carbamoyl was used.In the cyclic acid group(no-TXA),both groups matched the known confounding factors and scored favorably.Patients who received tranexamic acid(TXA)and those who did not receive the drug(no-TXA)had a maximum of 1 : 5 ratios are matched and their tendencies are compared.There were 40 patients who met the inclusion criteria and 10 patients(25%)used tranexamic acid(TXA),including 5 males and 5 females.The average age(years)was 79.1 ± 7.1;no tranexamic acid was used.(no-TXA)patients 30(75%),including 12 males and 18 females,mean age(years)78.7 ± 7.3;TXA and no-TXA group in age,gender,length of stay,length of surgery,surgical incision There were no statistically significant differences in general data such as size,anesthesia,injury to operation time,preoperative hb,preoperative hematocrit,surgical site,and anticoagulant use.In the TXA group,1 g of tranexamic acid was instilled into the pre-epidermal transection,and the dripping was completed rapidly.Intravenous and anticoagulant therapy were performed according to the clinical route between the two groups.The statistical results were obtained using R software and Empower Stats(R)3.43.A retrospective multivariate regression analysis was used.Results:The use of tranexamic acid before incision before hemoglobin loss on the first postoperative day was less than 7.5g/l P <0.05,in which the apparent hemoglobin loss rate was significantly reduced(hemoglobin drop HB drop> 18g/l 20% vs 80% P <0.001),statistically significant,equivalent to preoperative infusion of 1U-1.5U concentrated red blood cells;transfusion rate decreased(0.0%-16.5% p=0.168),compared with the relevant research data,has clinical significance;all included in the study 40 No cases of infection,fatal thrombosis,or death occurred during the hospitalization period.No statistically significant differences were found between the two cases.Conclusions:This study supports the use of TXA in the treatment of senile hemiarthroplasty to reduce postoperative hemoglobin loss,reduce blood loss,and reduce blood transfusion rates,but this study has inherent limitations of observation and analysis.