Effect of tranexamic acid on perioperative blood loss, D-Dimer and fibrinogen in total knee arthroplasty / 中国医师杂志

ABSTRACT

Objective To investigate the effects of tranexamic acid (TXA) on perioperative blood loss,D-Dimer and fibrinogen (FIB) in total knee arthroplasty (TKA).Methods A prospective study,from December 2016 to November 2017 patients with end-stage knee osteoarthritis underwent unilateral TKA were randomly divided into two groups.Patients in treatment group received two doses of 15 mg/kg TXA by intravenous inffusion 1 hour pre-operation and before the release of tourniquet;the control group was replaced with the same amount of saline.The preoperative and 3 days post-operation hemoglobin,hematocrit value,drainage,blood transfusion were recorded.The D-Dimer and FIB were dynamically monitored before operation and 1,3,7,14 d after the operation.And there were also observations for whether they had deep vein thrombosis and both lower limbs of all patients were examined by the color Doppler ultrasonography 14 days after operation.Results The drainage and the total blood loss in treatment group was significantly less than in control group (P ＜ 0.01,P ＜ 0.05).The volume of both allogeneic and autologous blood transfusion in treatment group were significantly less than those in the control group (P ＜0.01).The ratio of allogenic blood transfusion was 14.6％ (6/41) in treatment group,38.1％ (16/42) in control group (P ＜ 0.01).D-dimer at 1,3d post-operation in treatment group was significantly lower than that in the control group (P ＜0.05),but the difference was getting smaller at 7,14d post-operation (P ＞0.05).FIB at any time point between the two groups was no significant difference (P ＞ 0.05).There was no symptomatic deep venous thrombosis (DVT) in all of the three groups within 14 days.Conclusions The TXA infused intravenous can significantly decrease drainage,the total blood loss and blood transfusion without increasing risk for DVT in TKA.but early post-operation TXA could affect the level of D-dimer,thus affecting the value of early warning of DVT.