The Effect Of Topical Application Of Tranexamic Acid Combined With A Closed Drainage Tube On Blood Loss After Primary Total Hip Arthroplasty

Objectives:Observing the influence on the bleeding volume of appliying tranexamic acid topically combined with clipping the blood drainage 4h after primary total hip arthroplasty and exploring its efficacy and safety.Method:A retrospective analysis was performed in this study, The cases were selected in accordance with the inclusive and exclusive criterions come from the Department of orthopedics-The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine and the Lower limb ward-Sichuan Provincial Orthopedics Hospital from January 2014 to October 2015. According to different hemostasis methods were divided into observation group and control group and 30 cases were collected in each group.Both used tranexamic acid 1.0g preoperative,The observation group dilut tranexamic acid 1.0g in 20ml saline and perfused to the hip joint through the drainage tub after it was placed, The control group was treated with continuous negative pressure drainage. Keeping an account of hemoglobin and hematocrit on Preoperative and postoperative 1,3,7d, Calculation of total blood loss, postoperative drainage volume, hidden blood loss. To observe and record the occurrence of deep vein thrombosis or infection cases, the number of blood transfusion, adverse drug reactions, Such as:dizziness, headache, blurred vision, nausea, vomiting, fatigue, etc. To carry out statistical analysis of the survey results, in order to evaluate the efficacy and safety of the two groups.Results:1. Compare between the two groups. No obvious statistically significant in the Hemoglobin and hematocrit levels before operation(P> 0.05).2.The changes of hemoglobin in the experimental group and the observation group were statistically significant at 1,3 and 7 days after operation (P<0.05), The changes of hematocrit of these two group were statistically significant at 3 and 7 days after operation (P<0.05). There was a significant difference in the total blood loss, postoperative lead flow and the amount of hidden blood loss(P<0.05).There were no significant differences in cases of blood transfusion, deep vein thrombosis or pulmonary embolism, the number of infections after operation and adverse drug reactions between two groups (P>0.05)Conclusion:1.The clinical study shows that partial use of tranexamic acid 1.0g combined with closed plasma drainage tube 4h more effectively than Intravenous use continuous negative pressure drainage in reducing the bleeding volume after primary total hip arthroplasty.2. Two groups neither increase the postoperative deep vein thrombosis or pulmonary embolism, the number of infection cases and the incidence of adverse drug reactions.