| Objective:To explore the more effective and safer application of tranexamic acid(TXA)in total hip arthroplasty without drainage tube.Methods:A retrospective analysis of 88 eligible patients who underwent primary total hip arthroplasty(THA)through lateral approach from May 2016 to December 2020 was selected.Among them,42 patients received intravenous tranexamic acid(intravenous group),and 46 patients received tranexamic acid around the joint cavity combined with intravenous tranexamic acid(combination group).For total hip arthroplasty,2.0 g of tranexamic acid was added to 100 mL of 0.9%NaCl injection 0.25 h before the operation in the intravenous group,and 1.0 g of tranexamic acid was added to 100 mL of 0.9%NaCl 0.25 h before the operation in the combined group.Intravenous infusion of 9%NaCl injection,1.0 g tranexamic acid and 100 mL of 0.9%NaCl solution were injected around the joint cavity before the skin was sutured.No drainage device was placed in the intravenous group and the combined group after operation.The hospitalization days of the two groups were compared.,operation time,total postoperative blood loss,dominant blood loss,hidden blood loss,hemoglobin immediately after operation,hemoglobin on the 1st day after operation,hemoglobin on the 3rd day after operation,hemoglobin on the 5th day after operation,and 7th day after operation Day hemoglobin,maximum hemoglobin drop during this period,HHS score before and after surgery,etc.Results:1.The total amount of postoperative blood loss,the amount of explicit blood loss,and the amount of hidden blood loss in the combined group were lower than those in the venous group.Volume:188.33±55.08mL in the vein group,154.78±39.71 mL in the combined group,hidden blood loss,140.33±35.87mL in the vein group,125.23±31.37mL in the combined group,total postoperative blood loss,dominant blood loss,hidden blood loss in both groups There was a statistically significant difference in blood loss(P<0.05).2.The immediate postoperative hemoglobin of the combined group,as well as the hemoglobin on the 1st day,the 3rd day,the 5th day,and the 7th day after the operation were higher than those in the intravenous group.113.36±2.41g/L,115.59±12.97g/L,respectively,107.93±12.16g/L,113.80± 14.41 g/L on the first postoperative day,102.83± 11.66g/L,108.26 on the third postoperative day ± 12.63g/L,111.36±9.73g/L,117.50± 12.81g/L on the fifth postoperative day,112.50± 13.48g/L,118.66± 12.40g/L on the seventh postoperative day,immediate postoperative hemoglobin,surgery After the first day,the third day,the fifth day,and the seventh day,there were significant differences in the hemoglobin(P<0.05).The maximum decrease of hemoglobin:the intravenous group was 29.79±8.69 g/L;the combined group was 24.93±7.62 g/L,the difference was statistically significant(P<0.05),and the maximum decrease of hemoglobin in the combined group was smaller.3.The HHS score of the combined group was higher than that of the intravenous group at the 3rd month after the operation,and the postoperative HHS score of the intravenous group and the combined group was significantly different by statistical software analysis(P<0.05).4.The total hospitalization time between the intravenous group and the combined group was significantly different by statistical software analysis(P<0.05).5.There were no complications of venous embolism,cardiovascular and cerebrovascular and other systems in the two groups after operation.Conclusion:In the case of total hip arthroplasty without a drainage tube,the combination of intravenous tranexamic acid and local application can significantly reduce postoperative blood loss and shorten hospitalization compared with intravenous tranexamic acid alone at the same dose.It can also reduce the initial postoperative pain,which is of great significance to the recovery of the patient’s hip joint function in the early postoperative period,and is worthy of promotion in THA. |
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