Intraarticular TXA Administration with Appropriate Timing of Clamping and Appropriate Dose is More Effective Than IV Administration.

IF 0.4 4区医学 Q4 ORTHOPEDICS

Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca Pub Date : 2024-01-01 DOI:10.55095/achot2024/019

F Emre, E Uluyardimci, M Tahta, Ç Işik

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引用次数: 0

Abstract

Purpose of the study: Our aim was to compare the effects of intraarticular and intravenous (IV) tranexemic acid (TXA) application on bleeding and complication rates in patients who underwent total knee arthroplasty (TKA).

Material and methods: Between 2017 and 2021, 406 patients who underwent TKA with 2 g of IV TXA and retrograde 1.5 g of TXA applied through the drain were included in the study. Of the patients, 206 were in the IV TXA group. Preoperative and postoperative hemoglobin levels, drain output, BMI, ASA score, blood loss, and the number of transfused patients were recorded. Complications such as symptomatic venous thromboembolism were also recorded.

Results: There was no significant difference between the two groups in terms of age, sex, American Society of Anesthesiologists (ASA) score, or BMI (p = 0.68, 0.54, 0.28, 0.45). Total drain output and blood loss were significantly higher in the IV TXA group than in the intraarticular TXA group (p < 0.0001, p < 0.0001). Eighteen patients in the IV TXA group and 1 patient in the intraarticular TXA group received a blood transfusion (p < 0.0001). There was no difference between the two groups in terms of preoperative hemoglobin or platelet count (p = 0.24). However, postoperative hemoglobin level was higher in the patients who received intraarticular TXA (p=0.0005). More thromboembolism events were seen in the IV TXA group (p < 0.0001).

Conclusions: Intraarticular TXA application reduces blood loss more than IV application, reduces the blood transfusion rate, and causes fewer complications.

Key words: tranexemic acid, total knee arthroplasty, intraarticular injection, blood loss, blood transfusion.

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与静脉注射相比，在适当的时间夹闭和适当的剂量下进行关节内注射 TXA 更为有效。

研究目的我们的目的是比较关节内和静脉注射（IV）氨甲环酸（TXA）对接受全膝关节置换术（TKA）患者出血和并发症发生率的影响：2017年至2021年间，研究纳入了406例接受TKA手术的患者，通过引流管静脉滴注2克TXA和逆行滴注1.5克TXA。其中，206 名患者属于静脉注射 TXA 组。研究记录了术前和术后的血红蛋白水平、引流管输出量、体重指数、ASA评分、失血量和输血人数。此外，还记录了症状性静脉血栓栓塞等并发症：两组患者在年龄、性别、美国麻醉医师协会（ASA）评分或体重指数方面无明显差异（P = 0.68、0.54、0.28、0.45）。静脉注射 TXA 组的总排出量和失血量明显高于关节内 TXA 组（p < 0.0001，p < 0.0001）。静脉注射 TXA 组的 18 名患者和关节内 TXA 组的 1 名患者接受了输血（P < 0.0001）。两组患者术前血红蛋白和血小板计数没有差异（P = 0.24）。不过，接受关节内 TXA 的患者术后血红蛋白水平更高（p=0.0005）。静脉注射TXA组的血栓栓塞事件较多（p < 0.0001）：关键词：氨甲环酸；全膝关节置换术；关节内注射；失血；输血。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca ORTHOPEDICS-

CiteScore

0.70

自引率

25.00%

发文量

期刊介绍： Editorial Board accepts for publication articles, reports from congresses, fellowships, book reviews, reports concerning activities of orthopaedic and other relating specialised societies, reports on anniversaries of outstanding personalities in orthopaedics and announcements of congresses and symposia being prepared. Articles include original papers, case reports and current concepts reviews and recently also instructional lectures.