Analysis Of The Efficacy And Safety Of Preoperative And Intraoperative Intravenous Tranexamic Acid In Tumor Resection And Knee Arthroplasty

Objective:At present,tumor type knee arthroplasty is widely used in the reconstruction of bone defects after the resection of knee malignant tumors.Due to its large amount of surgical bleeding,people pay more and more attention to how to reduce bleeding in the perioperative period,in order to prevent the occurrence of bleeding related complications and postoperative complications such as blood transfusion and infection.Tranexamic acid(TXA)has currently achieved good results in knee arthroplasty including osteoarthritis,and its hemostatic effect is obvious.However,the efficacy and safety of tranexamic acid in oncologic knee prosthesis replacement remain controversial.This study investigated the efficacy and safety of TXA when administered intravenously in oncologic knee arthroplasty.Methods: We retrospectively reviewed the case data of 40 patients,27 males and 13 females,aged 10-67 years,mean age(32.1 ± 16.7)years,who underwent tumor type artificial knee replacement due to primary bone malignancy from June 2017 to March 2021.The experimental group consisted of 14 patients treated with txa1 G ～ 1.5 g,and 26 patients who did not use TXA as a control group,had preoperative blood tests,coagulation and other indicators,and daily blood tests 3 days after operation,And the drainage volume was recorded,and the deep vein color ultrasound of both lower limbs was reviewed 7 days after operation.Results: intraoperative blood loss in the experimental group(368.6 ± 213.4)was less than that in the control group(605.8 ± 378.8),and the difference was statistically significant(P < 0.05).The postoperative drainage volume of the experimental group(333.6± 220.7)was significantly less than that of the control group(573.5 ± 380.6),and the difference was statistically significant(P < 0.05).The transfusion rate in the experimental group(50%)was significantly smaller than that in the control group(84%),and the difference was statistically significant(P < 0.05).No patients in either group developed deep vein thrombosis and pulmonary embolism after surgery.Conclusions: preoperative intravenous administration of tranexamic acid can significantly reduce postoperative drainage,reduce the blood transfusion rate,and reduce the risk of perioperative anemia related complications in patients with tumor type artificial knee arthroplasty,and it is easy,safe,and economical to operate.