ABSTRACT
Objective To assess the effect and safety of intraarticular infusion combined with intravenous injection of tranexamic acid on hemorrhage in patients underwent total knee replacement (TKR).Methods A total of 180 patients who underwent TKR in the People's Hospital of Hebi City from January 2014 to January 2017 were selected.The patients were divided into control group,low dose group and high dose group according to the tranexamic acid dose,60 cases in each group.All patients were treated with tranexamic acid 10 mg · kg-1 by intravenous drip within one hour before operation.After the incisions were sutured,the patients in the control group were treated with physiological saline 100 mL by intraarticular infusion,the patients in the low dose group and high dose group received intraarticular infusion of tranexamic acid 1 and 2 g respectively,the drainage tube was opened after one hour's occlusion.The operation time,hemoglobin level,postoperative blood loss,total blood loss and complications were observed and recorded.Results There was no significant difference in hemoglobin level in the three groups before operation (P ＞ 0.05).The hemoglobin level in the high dose group was significantly higher than that in the low dose group and the control group (P ＜ 0.05),but there was no significant difference in hemoglobin level between the low dose group and the control group at one day after operation (P ＞ 0.05).The hemoglobin level in the low dose group and the high dose group was significantly higher than that in the control group (P ＜ 0.05),and it in the high dose group was significantly higher than that in the low dose group at two days after operation (P ＜ 0.05).There was no significant difference in the operation time in the three groups (P ＞ 0.05).The postoperative blood loss and total blood loss in the low dose group and the high dose group were significantly lower than those in the control group (P ＜ 0.05),and them in the high dose group were significantly lower than those in the low dose group (P ＜ 0.05).The incidence of complications in the control group,low dose group and high dose group was 8.33％ (5/60),10.00％ (6/60) and 8.33％ (5/60) respectively,there was no significant difference in the incidence of complications among the three groups (x2 =0.100,P ＞ 0.05).Conclusion Intraarticular infusion combined with intravenous injection of tranexamic acid can effectively reduce blood loss in patients with TKR.Increasing the dose of intraarticular infusion of tranexamic acid within a certain range can further improve the hemostatic effect,and it does not increase the complications.