Effect of postoperative application of tranexamic acid on recovery and prognosis after unilateral total hip arthroplasty / 中国医师进修杂志

ABSTRACT

study the effect of postoperative application of tranexamic acid on recovery and prognosis of unilateral total hip arthroplasty. Methods One hundred and twenty patients who received unilateral total hip arthroplasty in 541st General Hospital of Dongzhen Town from August 2016 to August 2018 were divided into observation group and control group by random number table method, with 60 cases in each group. The control group received intravenous injection of tranexamic acid 10 min before skin incision after anesthesia; on the basis of the control group, the observation group was given tranexamic acid intravenously again 3 h after operation, and the control group was no longer given repeated injection of tranexamic acid. The hemorrhage, hemoglobin (Hb), hematocrit(HCT), hip joint Harris score and complications were compared between the two groups. Results There was no significant difference in intraoperative blood loss and transfusion between the two groups (P＞0.05); the drainage volume, total blood loss, dominant blood loss and recessive blood loss in the observation group were lower than those in the control group [(227.43 ± 20.14) ml vs. (280.91 ± 23.56) ml, (601.01 ± 42.84) ml vs. (667.04 ± 49.21) ml, (281.93 ± 18.50) ml vs. (322.06 ± 21.23) ml, (330.94 ± 21.73) ml vs. (370.03 ± 25.90) ml] (P＜0.05). After operation 3 d, the levels of Hb and HCT in observation group were higher than those in control group [(117.07 ± 9.60) g/L vs. (102.19 ± 8.31) g/L, (35.05 ± 2.91)% vs. (32.01 ± 2.77)%] (P＜0.05). After operation 2 weeks and 1 month after operation, the hip joint Harris score in observation group was higher than that in control group [(52.03 ± 4.02) scores vs. (48.37 ± 5.05) scores, (67.86 ± 5.29) scores vs. (61.23±5.10) scores] (P＜0.05). There was no significant difference in the occurrence of intermuscular venous thrombosis, local hematoma and incision exudation between the two groups(P＞0.05). Conclusions On the basis of preoperative application of tranexamic acid, combined postoperative application of tranexamic acid can significantly reduce the blood loss after unilateral total hip arthroplasty, and help the early recovery of joint function, without increasing complications and with high safety.