The Effects Of Tranexamic Acid On Blood Loss In Total Knee Arthroplasty

Objectives: This paper is aimed to study the effects of intravenous drip tranexamic acid in small dose combined joint articular cavity flushing with tranexamic acid on blood loss in total knee arthroplasty(TKA)and to compare this curative effect with that in large dose.Methods: Patients with knee osteoarthritis undergoing unilateral knee replacements for the first time from 2015-01-06 to 2016-01-06 have been selected with a total of 40 cases which were randomly divided into test group and control group equally.The test group of 20 cases receives a small dose of(100ml:0.5g)tranexamic acid and sodium chloride injection via intravenous drip before TKA,and tranexamic acid and sodium chloride injection(100ml: 0.5g)soaking and flushing joint cavity for 10 minutes intraoperatively.Control group of 20 cases receives sodium chloride injection(100ml:0.9g)via intravenous drip before TKA,and sodium chloride soaking and flushing joint cavity intraoperatively.Intraoperative blood loss,flow rate and blood transfusion in both groups are recorded.Via comparing the preoperative and postoperative changes of red blood cells deposited value,the total amount of lost red blood cells,recessive red blood cell loss as well as the dominant red blood cell loss can be calculated.Results: there is no significant difference(P>0.05)between height,weight,body mass index(BMI),preoperative RBC deposition of patients in two cases.In test group,the average intraoperative blood loss is 232.50±66.40 ml and control group 316.50±82.93 ml,P<0.05;in test group,transfused blood amount is 390 + 102 ml and control group 590±180ml,P<0.05;in test group,the flow rate is 227.25±71.85 ml and control group 431.5±108.25 ml,P<0.05;in test group the total amount of red blood cell loss is 626.83±109.45 ml,and control group 1015.96±175.03 ml,P<0.05;in test group the dominant red blood cell loss is 163.57±31.31 ml and control group 240.18±50.44 ml,P<0.05;in test group recessive red blood cell loss is 463.27±110.55 ml,and control group 775.78±163.63 ml,P<0.05.There are significant differences between intraoperative blood loss,intraoperative blood transfusion,transfused blood amount,the flow rate,the total amount of red blood cell loss,dominant red blood cell loss and recessive red blood cell loss.There are no statistical significance in postoperative symptomatic thrombosis,the number of blood transfusion and wound healing.Conclusion: A small dose of tranexamic acid via intravenous drip combined tranexamic acid flushing articular cavity can significantly reduce the amount of total cell loss,dominant red blood cell loss,recessive red blood cell loss,intraoperative blood loss,intraoperative blood transfusion and flow rate.The symptomatic thrombosis cannot increase.