Effects Of Tranexamic Acid Sequential Application Of Femoral Neck Fracture In Aged Patients On Perioperative Blood Loss After Total Hip Arthroplasty

Objective: To explore the multiple pathways, sequential application of TXA and postoperative drainage tube on the effect of perioperative blood loss, the effectiveness and security of the proposed scheme.Methods: We chose 41 patients who received unilateral total hip arthroplasty due to femoral neck fracture from June 2015 to June 2014;Group A(n=23), 10 male and 13 female patients were treated by multiple routes and sequential therapy;Without the use of TXA and clamping of the drainage tube for the Group B(n=18), male 8 cases, female 10 cases;Group A 15 minutes before the rapid infusion of TXA 1.0g; the drainage tube placed in the fascia, through the drainage tube injection of TXA 30 ml after wound closure, closed drainage for 6 hours; 3 hours after infusion of 1.0g TXA. The B group do not give the above measures.Results: Group A and group B, the amount of bleeding, postoperative drainage, postoperative occult blood loss and perioperative total blood loss, the results showed that the difference was statistically significant(P <0.01); There was no significant difference in postoperative wound infection, pulmonary embolism / deep vein thrombosis, postoperative cognitive dysfunction in A and B groups, and the difference of blood transfusion rate was P < 0.05.Conclusions: Multiple pathways, sequential application of TXA, postoperative drainage tube, early postoperative anticoagulation, in the reduction of elderly femoral neck fracture THA perioperative bleeding is Effective and safe, especially for reducing total blood loss and postoperative hidden blood loss.