Effect Of Preoperative Tranexamic Acid On Drainage After Primary Total Hip Arthroplasty

Objective To investigate the effect of preoperative tranexamic acid on drainage after primary total hip arthroplasty.Methods A total of 92 patients who underwent total hip arthroplasty from November 2016 to September 2018 were enrolled.According to the random number table method they were divided into control group(n=46)and study group(n=46).Total hip arthroplasty was performed in both groups.After the anesthesia was effective,the study group received intravenous infusion of tranexamic acid before the incision,and the control group received intravenous infusion of the same amount of normal saline.Perioperative blood loss(recessive blood loss,dominant blood loss,postoperative drainage,intraoperative blood loss,total blood loss),blood volume(PBV)and coagulation function [fibrinogen(FiB)],activated partial prothrombin time(APTT),prothrombin time(PT)level,preoperative and postoperative 1 d,4 d and 7 d hemoglobin and hematocrit levels,complications(muscle septal thrombosis),the incidence of ecchymosis,nausea,and infection in the lower extremities were counted.Results(1)perioperative blood loss: the study group's recessive blood loss,dominant blood loss,postoperative drainage,intraoperative blood loss,total blood loss was less than the control group(P<0.05);(2)PBV and Coagulation function: There was no significant difference in FiB,APTT,PT and PBV levels between the study group and the control group(P>0.05).(3)Hemoglobin: Hemoglobin levels on the 1st,4th and 7th day after operation.Compared with the preoperative,the hemoglobin level increased on the 7th day after operation,and the hemoglobin level of the study group was higher than that of the control group at each time period(P<0.05).(4)Hematocrit: the postoperative group At 1 d,4 d and 7 d,the hematocrit level was lower than that before surgery,and the hematocrit level was increased on the 7th day after operation.The hematocrit level of the study group was higher than that of the control group at each time period.(P<0.05);(5)Complication rate: There was no significant difference between the study group's complication rate of 8.70%(4/46)and the control group of 10.87%(5/46)(P>0.05).(6)Postoperative drainage volume,The Postoperative drainage volume of the study group was lower than that of the control group at each time period,they both have the fast rate of drainage in 6h.Conclusion The application of tranexamic acid before total hip arthroplasty for the first time can effectively reduce perioperative blood loss and postoperative drainage,avoiding a significant decrease in hemoglobin and hematocrit,and will not adversely affect the patient's coagulation function.The complication rate is low and safe,they have the fast rate of drainage in 6h.