Abstract:Objective To investigate the clinical efficacy and safety of tranexamic acid combined with sucrose iron in total knee arthroplasty (TKA).Methods From January 2016 to June 2017,180 patients were enrolled in this study and randomly assigned to tranexamic acid combined iron group (combined group),tranexamic acid group and iron group.Record replacement at admission,the day before surgery,after surgery,three,five days of hemoglobin concentration,hematocrit.The number of blood loss,postoperative drainage and postoperative blood transfusion were recorded.Besides,the amount of preoperative blood volume,total blood loss were recorded.Results The average age of the patients was 65 years.All preoperative data were not statistically significant (P>0.05).The levels of preoperative hemoglobin in combination group and iron group were significantly higher than those in group tranexamicacid group (P<0.05).At the same time,the blood loss and total blood loss were significantly lower in the combined group than in the group (P<0.05).There were no complications such as infection,deep vein thrombosis,pulmonary embolism during follow-up.Conclusion Tranexamic acid and iron can effectively improve the perioperative hemoglobin concentration,reduce the total blood loss,reduce postoperative blood transfusion.
[1]Yi Z,Bin S,Jing Y,et al.Tranexamic acid administration in primary total hip arthroplasty:a randomized controlled trial of intravenous combined with topical versus single-dose intravenous administration[J].J Bone Joint Surg(Am),2016,98(12):983-991.
[2]Ma J,Huang Z,Shen B,et al.Blood management of staged bilateral total knee arthroplasty in a single hospitalization period[J].J Orthop Surg Res,2014,9(1):116.
[3]Phan DL,Ani F,Schwarzkopf R.Cost analysis of tranexamic acid in anemic total joint arthroplasty patients[J].J Arthroplasty,2016.,31(3):579-582.
[4]Aguilera X,Martinez-Zapata MJ,Bosch A,et al.Efficacy and safety of fibrin glue and tranexamic acid to prevent post operative blood loss in total knee arthroplasty:a randomized controlled clinical trial[J].J Bone Joint Surg(Am),2013,95(22):2001-2007.
[5]Alshryda S,Mason J,Vaghela M,et al.Topical(intra-articular)tranexamic acid reduces blood loss and transfusion rates following total knee replacement:a randomized controlled trial(TRANXK)[J].J Bone Joint Surg(Am),2013,95(21):1961-1968.
[6]Munoz M,Gomez-Ramirez S,Cuenca J,et al.Very-short-term perioperative intravenous iron administration and postoperative outcome in major orthopedic surgery:a pooled analysis of observational data from 2547 patients[J].Transfusion,2014,54(2):289-299.
[7]孟涛.铁剂与氨甲环酸联合应用对单侧全膝关节置换术围手术期失血及安全性的影响[J].安徽医学,2015(11):1325-1329.
[8]Nadler SB,Hidalgo JH,Bloch T.Prediction of blood volume in normal human adults[J].Surgery,1962,51(2):224-232.
[9]Gross JB.Estimating allowable blood loss:corrected for dilution[J].Anesthesiology,1983,58(3):277-280.
[10]Springer BD,Odum SM,Fehring TK.What is the benefit of tranexamic acid vs reinfusion drains in total joint arthroplasty? [J].J Arthroplasty,2016,31(1):76-80.
[11]Eeles A,Baikady RR.Perioperative blood management[J].Indian J Anaesth,2017,61(6):456-462.
[12]Alexander DP,Frew N.Preoperative optimisation of anaemia for primary total hip arthroplasty:a systematic review[J].Hip Int,2017,27(6):515-522.
[13]Seligsohn U.Treatment of inherited platelet disorders[J].Haemophilia,2012,18(Suppl 4):161-165.
[14]Rodeghiero F.Management of menorrhagia in women with inherited bleeding disorders:general principles and use of desmopressin[J].Haemophilia,2008,14(Suppl 1):21-30.
[15]Ragni MV,Machin N,Malec LM,et al.Von willebrand factor for menorrhagia:a survey and literature review[J].Haemophilia,2016,22(3):397-402.
[16]Prasad N,Rajamani V,Hullin D,et al.Post-operative anaemia in femoral neck fracture patients:does it need treatment? a single blinded prospective randomised controlled trial[J].Injury,2009,40(10):1073-1076.
[17]郑颖.铁剂应用于老年人关节置换术后的随机对照研究[J].中华临床医师杂志(电子版),2012(4):92-95.
[18]Gomez-Barrena E,Ortega-Andreu M,Padilla-Eguiluz NG,et al.Topical intra-articular compared with intravenous tranexamic acid to reduce blood loss in primary total knee replacement:a double-blind,randomized,controlled,noninferiority clinical trial[J].J Bone Joint Surg(Am),2014,96(23):1937-1944.
[19]Kayupov E,Fillingham YA,Okroj K,et al.Oral and intravenous tranexamic acid are equivalent at reducing blood loss following total hip arthroplasty:a randomized controlled trial[J].J Bone Joint Surg(Am),2017,99(5):373-378.
[20]Nawabi DH.Topical tranexamic acid was noninferior to intravenous tranexamic acid in controlling blood loss during total knee arthroplasty[J].J Bone Joint Surg(Am),2015,97(4):343.
[21]Wong J,Abrishami A,El Beheiry H,et al.Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty:a randomized,controlled trial[J].J Bone Joint Surg(Am),2010,92(15):2503-2513.
[22]Wu YG,Zeng Y,Shen B,et al.Combination of erythropoietin and tranexamic acid in bilateral simultaneous total hip arthroplasty:a randomised,controlled trial[J].Hip Int,2016,26(4):331-337.