Perfusion Tranexamic Acid Combined Continuous Drainage To The Study Of TKA Blood Loss Problem

OBJECTIVE: To explore the effect of Articular cavity perfusion tranexamic acid and intermittent drainage on Blood loss after knee arthroplasty,and to explore a kind of effective method to reduce blood loss after knee arthroplasty.Methods : We choose many 60 years old patients who have an knee arthroplasty between December 2015 and October 2016 in laiwu orthopaedic hospital attached to taishan medical college as the research object.This sample is composed of 41 man and 49 women.Their age is between 61 to 61 years old and average 70.4 years old.Among them,15 patients with osteoarthritis,and 75 patients with rheumatoid.They don't have internal diseases.each group patients do surgery using tourniquet by same physicians,they both have the knee arthroplasty,and the prosthesis used in operation are stable joints provided by Taiwan company,before closing the wound,puting drainage tube's conventional side holes in articular cavity,pressure dressing afer suturing wounds,according to the postoperatived infusion drug by drainage tube and postoperative drainage way.we randomly divided patients into three groups.Group A were infused 30 ml 0.9% physiological saline using drainage tube.Then,we clip rainage tube 2 hours.Next opening drainage tube tem minutes and clipping again.Repeating above steps five times.Group B: Mixing 0.5g tranexamic injection and 20 ml 0.9% saline,and perfusing the mixture liquid to joint using the drainage tube.Then starting delay open drainage after clipping the drainage tubel 2 hours;Group C: Mixing 0.5g tranexamic injection and 20 ml 0.9% saline,and perfusing the mixture liquid to joint using the drainage tube.Then starting intermittent drainage.We record the following informations:(1)postoperative drainage bago flow of the three groups patients(2)blood routine examination and hemoglobin values of All patients at preoperation and 48 hours after postoperation.(3)measuring perimeter situated in suprapatellar 10 cm of all patients when Removing drainage tube at preoperation and 48 hours after postoperation.(4)patients routine records about postoperative blood transfusion and calculating rate of blood transfusion(5)wound healing rate about two weeks after surgery,according to the postoperative state of incision healing(6)knee joint activity about 2 weeks after the operation.Using SPSS 16.0 software analysis the test data,to determine the P value and whether the gap have clinical significance.Results: we receive the complete follow-up data of 90 patients operation time(55-140 min),hospitalization days(14 to 20 days),90 patients with superficial infection,7 cases of incision wound healing by dressing,incision healing rate was 100%.3 patients transfuse of group C and group B of,14 patients of group A.it is no statistical significance to measure the suprapatellar perimeter and the degree of joint activities.The best group about postoperative drainage volume and the change of HB value is group C,the second group is group B,the worst group is group A,.Conclusion :Perfusion of tranexamic acid saline combined with intermittent drainage can effectively reduce blood loss in patients with TKA.