Tranexamic acid injection through articular cavity and discontinuous clip pipe after total hip arthroplasty: changes in bleeding amount

doi:10.3969/j.issn.2095-4344.2014.40.001

Abstract

Abstract:

BACKGROUND: With the increased number of patients with total hip arthroplasty, blood source became less gradually. Simultaneously, the risk of a variety of serious diseases infected by blood transfusion troubled the patients. Thus, it is very important to find a method that can reduce blood transfusion and did not increase risk. There are reports addressing the application of tranexamic acid to reduce bleeding during total knee, total hip arthroplasty and spinal surgery.

OBJECTIVE: To explore the effects of injection with tranexamic acid through articular cavity and discontinuous clip pipe on blood loss, functional recovery and complication after total hip arthroplasty.

METHODS: A total of 99 patients, who received total hip arthroplasty because of femoral fracture or coxarthropathy from January 2011 to February 2014, were selected in this study. They were divided into tranexamic acid group (n=55) and control group (n=44). After skin suture, patients in the tranexamic acid group were injected with 2.0 g tranexamic acid dissolved in 20 mL physiological saline through articular cavity. After replacement, the drainage was opened after 2 hours of interval. From then on, the drainage was opened for 10 minutes every 4 hours. Patients in the control group received discontinuous clip pipe. Negative pressure drainage tube was pulled out at 48 hours after replacement. Blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit, preoperative, 3-hour postoperative fibrinogen, prothrombin time and activated partial thromboplastin time, 6-month postoperative hip Harris score and lower extremity deep vein thrombosis or pulmonary embolism were compared between the two groups.

RESULTS AND CONCLUSION: Significant differences in blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit were visible after replacement in patients of both groups (P < 0.05). Blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit were better in the tranexamic acid group than in the control group. No significant difference in preoperative, 3-hour postoperative fibrinogen, prothrombin time and activated partial thromboplastin time was detectable between the two groups (P > 0.05). No significant difference in 6-month postoperative hip Harris score was found between the two groups (P > 0.05). No lower extremity deep vein thrombosis was observed using Doppler ultrasonography at 3, 10 and 14 days after replacement in 99 patients. Lower extremity deep vein thrombosis or pulmonary embolism was not detected at 6 months after replacement. Above data indicated that injection with tranexamic acid through articular cavity and discontinuous clip pipe after total hip arthroplasty could obviously decrease postoperative blood loss and blood transfusion, and did not increase the risk of lower extremity deep vein thrombosis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: arthroplasty, replacement, hip, tranexamic acid, hemorrhage, venous thrombosis

CLC Number:

R318

Fan Fu-cheng, Gui Bin-jie. Tranexamic acid injection through articular cavity and discontinuous clip pipe after total hip arthroplasty: changes in bleeding amount[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(40): 6397-6402.

Figures/Tables 1

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