| Objective: To investigate the efficacy and safety of Tranexamic Acid(TXA)duri ng and after Total Tnee Arthroplasty(TKA).Methods:This study prospectively selected 80 patients who needed the first unilateral Total Knee Arthroplasty due to advanced Knee Osteoarthritis(KOA)in Anqing Municipal Hospital from October 2018 to March 2020.The patients were divided into two groups according to whether TXA was received or not,with 40 patients in each group.Observation group: 1g tranexamic acid was intravenously injected 30 minutes before surgery and after the prosthesis was installed and the tourniquet was loosened,and the drug was given every 3h within 24 hours after surgery.Control group: 100 ml of normal saline was given intravenously at the same time.Total intraoperative and postoperative blood loss and blood transfusion rate were compared between the two groups.The levels of interleukin-6(IL-6),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)in venous blood of 2 groups were compared before surgery,immediately after surgery,the first day,the second day and the third day after surgery.Postoperative blood routine,blood clotting and the incidence of lower extremity deep vein thrombosis(DVT)were detected between the two groups.Postoperative pain score,number of vomiting cases and muscle strength were compared between the two groups.Results: There were no significant differences in general information between the two groups,such as age,gender,body mass index(BMI),knee joint score(HSS),preoperative hemoglobin and hematocrit(P>0.05).The independent sample t test showed that the total blood loss in the control group(1067.35±92.73)m L was higher than that in the observation group(821.03±115.30)m L,and the difference was statistically significant(t=10.529,P<0.05).The blood transfusion rate in the control group(22.5%)was significantly higher than that in the observation group(5%),the difference was statistically significant(χ2=3.794,P<0.05).According to single-factor ANOVA,there were statistically significant differences in IL-6(F1= 9.36,F2=11.03,F3=11.07),ESR(F1=20.94,F2=18.90,F3=22.80)and CRP(F1=14.08,F2=12.10,F3=23.42)between the two groups on the first,second and third days after surgery(P<0.05).The regression results showed that the maximum changes of ESR(B=0.22,P=0.04),IL-6(B=0.14,P=0.03),and CRP(B=0.03,P=0.01)in TXA patients were smaller than those in the control group(B>0,P<0.10),and the corresponding index values were lower on the third day after surgery(B>0,P<0.10).There was no significant difference in preoperative and postoperative coagulation function between 2 groups(P>0.05).No deep vein thrombosis was found in both groups after lower extremity vascular color ultrasound.Postoperative pain,nausea,vomiting and recovery of muscle strength in observation group were better than control group,with statistical significance(P<0.05).Conclusion: 1.During the first perioperative period of unilateral TKA,multiple intravenous injections of tranexamic acid can effectively reduce intraoperative and postoperative blood loss and reduce the probability of blood transfusion.2.Intravenous injection of tranexamic acid can effectively inhibit the inflammatory response during the perioperative period of TKA and relieve the pain of patients.3.Tranexamic acid can significantly relieve patients’ pain after TKA,inhibit vomiting and promote muscle strength recovery,which is beneficial to postoperative rehabilitation of patients.4.The application of tranexamic acid in TKA has little interference with the coagulation indicators of patients,and does not increase the risk of complications such as thromboembolism,so it has good safety. |
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