The Research Of Two Approaches Of Tranexamic Application In Reducing Postoperative Hemorrhage After Unilateral TKA

Background As the total knee replacement has become the effective treatment of various knee end-stage disease,the postoperative hemorrhage has been troubling more and more joint orthopedist.The efficacy of Tranexamic acid to reduce of postoperative bleeding has attracted more and more attention,but for methods of administration remains controversial.Objective To study the efficacy of two different approaches of tranexamic acid :Intravenous dosing or Joint cavity to reduce hemorrhage after total knee replacement.Methods Select 60 patients from October 2015 to October 2016 who got unilateral total knee replacement.They were divided into three groups according to gender in stratified random grouping: group A(n = 20): No tranexamic acid application;Group B(n = 20): Static slowly drops of 15 mg/kg tranexamic acid 20 min before surgery cut skin,10 mg/kg tranexamic acid 3 h after surgery in the same way;Group C(n = 20),50 ml saline dilute with 1g tranexamic acid injected through the drainage tube after the operation,All three groups are clip drainage tube 2 h after surgery.Record each dominant and hidden blood loss after displacement ratio,blood transfusion,and observe whether there is a pulmonary embolism and clinical symptoms of lower extremity deep vein thrombosis.Results: The blood loss of peak 3 to 5 days postoperatively,dominant blood loss accounts for about one third of the total blood loss.Dominant and hidden blood loss of group B and group C patients is significantly reduced(P < 0.05);Group B and group C was no significant difference in blood loss(P > 0.05);Group C less than group B in the hidden blood loss significantly(P < 0.05);Number of group B and C groups of patients with blood transfusion and transfusion was less than group A significantly(P < 0.05);Three groups of patients had not been found lower extremity deep vein after the replacement of 14 d.Conclusion Tranexamic acid can significantly reduce the rate of blood loss and hidden blood loss,blood transfusion and transfusion volume per capita at the first dominant after unilateral total knee replacement,and does not increase the risk of lower extremity deep vein thrombosis,pulmonary embolism,and intravenous drug use is more effective than the others.