The Effect Of Tranexamic Acid On Early Postoperative Coagulation Function In Diabetic Patients With Knee Arthritis After Primary Unilateral TKA

ObjectiveTo explore the changes of the thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and platelet count(PLT)caused by tranexamic acid in patients with diabetes after the first unilateral TKA in blood coagulation parameters were evaluated to assess the influence of early postoperative coagulation function on diabetic patients.MethodsRandomly selected our hospital for the first time unilateral TKA patients with knee osteoarthritis from October 2016 to March 2018 in Guangzhou First People's Hospital.When admitted to hospital,the patients diagnosed with diabetes were divided into diabetes group;Patients with multiple normal blood glucose tests or those without diabetes mellitus were in the non-diabetic group : 20 in the diabetes group,18 in women,and 2 in men;20 in the non-diabetic group,19 in women,1 in men The age range of the two groups of patients was between 60-90 years old;the BMI index of both groups was controlled within 18.5-30.0 kg/m2;the patients in the two groups were given the same perioperative period except that diabetic patients had blood glucose control measures.In the treatment,both groups of patients were performed by the same group of doctors.During the operation,the tranexamic acid was instilled in approximately 10 minutes before the loose tourniquet.the change of the thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and platelet count(PLT)in the morning of two groups of patients were compared.Results1.Compared with the preoperative comparison between diabetes group and nondiabetic group,the APTT value in diabetes group was lower;compared with preoperative,on the 1th day after the operation APTT was lower in diabetes group,on the 4th day after the operation was elevated,on the 7th day after the operation was further elevated to preoperative level compared to the 4th day after the operation;non-diabetic group APTT After the Operation 1th Day began to decline,on the 4th day after the operation increased,on the 7th day after the operation increased further to preoperative level than the 4th day after the operation;there was no statistical difference between the two groups.2.Compared with diabetic and non-diabetic groups before operation,the value of TT in diabetes group was higher.The TT of diabetic patients fluctuates greatly,on the 1th day after the operation increases,on the 4th day after the operation decreases,and on the 7th day after the operation increases;on the 1th and 4th day after the operation TT decrease and the 7th day after the operation rises in non-diabetic group;there is no statistical difference between the two groups.3.The preoperative PLT values of diabetic and non-diabetic groups were basically the same;PLT of both groups showed a decrease on the 1th and 4th day after the operation,and on the 7th day after the operation increased to preoperative levels.There was no statistical difference between the two groups.4.Compared with preoperative diabetic and non-diabetic groups,the PT value of diabetes group was lower;on the 1th,4th and 7th day after the operation the PT of the two groups were all higher than before surgery.There was no statistical difference between the two groups.5.The preoperative FIB values of diabetic and non-diabetic groups were basically the same;on the 1th day after the operation the FIB of the two groups decreased,on the 4th and 7th day after the operation increased compared with preoperative;there was no statistical difference between the two groups.ConclusionKnee arthritis patients and knee arthritis patients with diabetes performed first-time unilateral total knee arthroplasty with intravenous infusion of 1 g of tranexamic acid,and there was no significant difference in early postoperative coagulation function between the two patients.