The Hemostasis Effect And Safety Analysis Of Tranexamic Acid In Total Hip Arthroplasty

ObjectiveTo analysis the hemostasis effect and safety of tranexamic acid (TXA) in primary unilateral total hip arthroplasty (THA).MethodsA retrospective analysis of ninety-seven patients with total hip arthroplasty from January2014to February2015were done. The patients were enrolled into3groups based on the use of TXA:no TXA group (thirty-five patients), topical TXA group (thirty-two patients), topical and intravenous TXA group (thirty patients). The sex, age, body mass index (BMI), preoperative hemoglobin (Hb)、hematocrit (HCT) intraoperative blood loss, postoperative drainage in48h, blood transfusions rate, and postoperative hemoglobin、hematocrit of patients in each group were collected. If there were clinical symptoms of deep venous thrombosis (DVT) or pulmonary embolism (PE), the doppler ultrasound of lower extremity vascular and pulmonary CTA were targeted to be examined postoperatively. ResultsThe results showed that there were no statistic significance in sex, age, body mass index (BMI), preoperative hemoglobin(Hb)、hematocrit (HCT), intraoperative blood loss、incidence of DVT/PE and other complications in the three groups (P/χ20.05). Compared with the no TXA group, group A and group B had reduced blood transfusion rate and drainage volume in48h postoperative (P<0.05). Group B and group C have the similar effectiveness in reducing transfusion rate and total blood loss without sacrificing safety (P>0.05). But the most important is that by adding intravenous TXA, patients can gain a smaller decline of hemoglobin (Hb) and hematocrit (HCT)(P＜0.05) postoperatively.ConclusionWe conclude that topical use of TXA following THA was effective in reducing blood loss and transfusion rate. And topical combined with intravenous TXA application could get the better hemostatic effect without increasing the risk of DVT/PE and other substantial complications.