Effect Of Tranexamic Acid On Recessive Blood Loss After Surgical Treatment Ofintertrochanteric Fracture

China is entering an aging society.With the further acceleration of the aging,there are more and more elderly people,and the number of patients with intertrochanteric fractures in the elderly and super senior age has increased year by year.In the past,most of the femoral intertrochanteric fractures were conservatively treated,but conservative treatment required long-term bed rest and limb braking,resulting in reduced blood flow velocity,and improved blood viscosity.Many factors easily cause deep venous thrombosis or pulmonary embolism and lungs in patients.Complications such as infections and decubitus are often cause patient death.Therefore,surgical treatment of intertrochanteric fractures is often used to restore the function of the fracture site as early as possible,so that patients can get out of bed early,which can reduce long-term bedridden complications and reduce patient mortality.The application of the proximal femoral nail is not only surgically small,firm and simple,but has been accepted by a wide range of orthopaedic clinicians.Clinically,the total blood loss of perioperative patients was significantly greater than the amount of dominant blood loss during surgery.It is speculated that patients may have some hidden blood loss,which is one of the main complications after surgery.More recessive blood loss can lead to anemia,even shock,which can seriously affect the prognosis of patients.Tranexamic acid is a synthetic derivative of lysine that blocks the interaction between lysine and plasmin,preventing fibrinolytic enzymes from binding to fibrin monomers,thereby inhibiting fibrin clot lysis.And to achieve the purpose of stopping bleeding.Tranexamic acid was widely used in the early stage of obstetrics and gynecology,urology and cardiovascular surgery to stop bleeding.A large number of reports have reported that intravenous tranexamic acid has a good hemostatic effect and does not increase perioperative infection and surgery.The risk of posterior venous thromboembolism.This article is mainly to illustrate the effect of intraoperative tranexamic acid on the prevention of invisible blood loss in the treatmentof intertrochanteric fractures in elderly patients with intramedullary fixation.Objective To analyze the effect of intravenous infusion of tranexamic acid on postoperative blood loss in patients with intertrochanteric fractures of the femur.Methods A total of 96 patients with intra-articular nail fixation in the femoral intertrochanteric fractures from September 2016 to September 2018 were enrolled.The patients were randomly divided into two groups.Forty-eight patients in the control group were instilled with 250 ml of normal saline 10 min before the incision,while 48 patients in the tranexamic acid group were intravenously infused with tranexamic acid 1 g in the first 10 min before the incision with 250 ml of normal saline.The mixture was compared and analyzed for postoperative bleeding volume,blood transfusion volume,drainage volume,hemoglobin concentration,postoperative blood transfusion rate,and postoperative complications.Results In this study,the concentration of hemoglobin in the tranexamic acid group was significantly higher than that in the control group.The transfusion rate,blood loss,blood transfusion volume and drainage volume of the tranexamic acid group were significantly lower than those of the control group.There was a significant difference(P<0.05).In this study,the incidence of postoperative complications in the tranexamic acid group was not significantly different from that in the control group(P>0.05).Conclusion In the treatment of intramedullary nailing of intertrochanteric fractures,intravenous tranexamic acid can effectively reduce the amount of postoperative recessive blood loss and reduce postoperative complications.It is worthy of popularization and application.