全膝关节置换术中使用氨甲环酸对输血需求和深静脉血栓发生率的回顾性研究

R. Rana, S. Lakhey, D. Jha, N. Chitrakar, J. Thakur, A. Poudel
{"title":"全膝关节置换术中使用氨甲环酸对输血需求和深静脉血栓发生率的回顾性研究","authors":"R. Rana, S. Lakhey, D. Jha, N. Chitrakar, J. Thakur, A. Poudel","doi":"10.3126/nmmj.v3i2.52361","DOIUrl":null,"url":null,"abstract":"BACKGROUND Total knee replacement is often associated with significant blood loss and increased rate of blood transfusion. Tranexamic acid is a potent anti-fibrinolytic agent and its use in major surgeries has shown to decrease blood loss as well as transfusion rates. It is used intravenous, oral and topical forms as well. This study aims to find out the effectiveness of systemic Tranexamic acid in terms of decrease in transfusion rate as well incidence of deep vein thrombosis (DVT) and thromboembolism. \nMATERIALS AND METHODS Total number of patients were 94 of which 58 had bilateral knees replacement and 36 patient underwent unilateral knee replacement over the period of 3 years (December 2018 –December 2021). All patients were screened for general condition as well as any coagulopathy pre –op. All patients were given IV form of Tranexamic acid followed by oral form for 3 days post operatively. Tourniquet was used in all cases and low molecular weight heparin (Clexane) 40 mg subcutaneous once a day for 1-2 days followed by oral aspirin was given for 6 weeks to all patients. SCD calf pumps were used for 4 to 5 days. \nRESULTS We found that incidence of blood transfusion was only 6.9% in our case series which was well within the incidence reported in varied literature on the use of Tranexamic acid in knee replacement surgery. There was no clinical feature of deep vein thrombosis / pulmonary embolism (DVT/PE) in any of our patients. \nCONCLUSION Use of Tranexamic acid is a safe and effective method for controlling blood loss and decreasing the transfusion rate after total knee replacement surgery. Its intravenous and oral forms are readily available and cost effective. Its use is not associated with DVT or PE.","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"121 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retrospective Study on transfusion requirements and deep vein thrombosis incidence with the use of Tranexamic acid on total knee replacement\",\"authors\":\"R. Rana, S. Lakhey, D. Jha, N. Chitrakar, J. Thakur, A. Poudel\",\"doi\":\"10.3126/nmmj.v3i2.52361\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND Total knee replacement is often associated with significant blood loss and increased rate of blood transfusion. Tranexamic acid is a potent anti-fibrinolytic agent and its use in major surgeries has shown to decrease blood loss as well as transfusion rates. It is used intravenous, oral and topical forms as well. This study aims to find out the effectiveness of systemic Tranexamic acid in terms of decrease in transfusion rate as well incidence of deep vein thrombosis (DVT) and thromboembolism. \\nMATERIALS AND METHODS Total number of patients were 94 of which 58 had bilateral knees replacement and 36 patient underwent unilateral knee replacement over the period of 3 years (December 2018 –December 2021). All patients were screened for general condition as well as any coagulopathy pre –op. All patients were given IV form of Tranexamic acid followed by oral form for 3 days post operatively. Tourniquet was used in all cases and low molecular weight heparin (Clexane) 40 mg subcutaneous once a day for 1-2 days followed by oral aspirin was given for 6 weeks to all patients. SCD calf pumps were used for 4 to 5 days. \\nRESULTS We found that incidence of blood transfusion was only 6.9% in our case series which was well within the incidence reported in varied literature on the use of Tranexamic acid in knee replacement surgery. There was no clinical feature of deep vein thrombosis / pulmonary embolism (DVT/PE) in any of our patients. \\nCONCLUSION Use of Tranexamic acid is a safe and effective method for controlling blood loss and decreasing the transfusion rate after total knee replacement surgery. Its intravenous and oral forms are readily available and cost effective. Its use is not associated with DVT or PE.\",\"PeriodicalId\":131440,\"journal\":{\"name\":\"Nepal Mediciti Medical Journal\",\"volume\":\"121 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-12-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nepal Mediciti Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3126/nmmj.v3i2.52361\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nepal Mediciti Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3126/nmmj.v3i2.52361","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:全膝关节置换术常伴有大量失血和输血率增加。氨甲环酸是一种有效的抗纤溶剂,在大手术中使用它可以减少失血和输血率。它可以静脉注射、口服和外用。本研究旨在了解全身氨甲环酸在降低输血率、深静脉血栓形成(DVT)和血栓栓塞发生率方面的有效性。材料与方法在2018年12月至2021年12月的3年期间,共94例患者,其中58例患者行双侧膝关节置换术,36例患者行单侧膝关节置换术。所有患者术前均筛查一般情况及任何凝血功能障碍。所有患者术后静脉注射氨甲环酸,口服3天。所有患者均予止血带治疗,同时给予低分子肝素40mg (Clexane)皮下注射,每天1次,持续1-2天,随后给予阿司匹林口服,持续6周。SCD小牛泵使用4 - 5天。结果:我们发现,在我们的病例系列中,输血的发生率仅为6.9%,这与各种文献中关于在膝关节置换手术中使用氨甲环酸的报道的发生率完全一致。所有患者均无深静脉血栓/肺栓塞(DVT/PE)的临床特征。结论氨甲环酸是控制全膝关节置换术后失血量和降低输血率的一种安全有效的方法。它的静脉注射和口服形式很容易获得,而且成本低廉。它的使用与DVT或PE无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retrospective Study on transfusion requirements and deep vein thrombosis incidence with the use of Tranexamic acid on total knee replacement
BACKGROUND Total knee replacement is often associated with significant blood loss and increased rate of blood transfusion. Tranexamic acid is a potent anti-fibrinolytic agent and its use in major surgeries has shown to decrease blood loss as well as transfusion rates. It is used intravenous, oral and topical forms as well. This study aims to find out the effectiveness of systemic Tranexamic acid in terms of decrease in transfusion rate as well incidence of deep vein thrombosis (DVT) and thromboembolism. MATERIALS AND METHODS Total number of patients were 94 of which 58 had bilateral knees replacement and 36 patient underwent unilateral knee replacement over the period of 3 years (December 2018 –December 2021). All patients were screened for general condition as well as any coagulopathy pre –op. All patients were given IV form of Tranexamic acid followed by oral form for 3 days post operatively. Tourniquet was used in all cases and low molecular weight heparin (Clexane) 40 mg subcutaneous once a day for 1-2 days followed by oral aspirin was given for 6 weeks to all patients. SCD calf pumps were used for 4 to 5 days. RESULTS We found that incidence of blood transfusion was only 6.9% in our case series which was well within the incidence reported in varied literature on the use of Tranexamic acid in knee replacement surgery. There was no clinical feature of deep vein thrombosis / pulmonary embolism (DVT/PE) in any of our patients. CONCLUSION Use of Tranexamic acid is a safe and effective method for controlling blood loss and decreasing the transfusion rate after total knee replacement surgery. Its intravenous and oral forms are readily available and cost effective. Its use is not associated with DVT or PE.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信