全膝关节置换术中氨甲环酸不同用法的疗效与安全性研究

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Abstract Objective To explore the perioperative efficiency and safety of different regimen of tranexamic acid (TA) in total knee arthroplasty (TKA).Methods We prospectively enrolled 187 patients operated on from April 1，2015 to January 31，2016 and randomly divided them in to two groups which were then named TA group (1 g of TA infused intravenous 20 minutes before tourniquet deflation and one dose of 1 g TA injected into articular cavity) and control group(1 g of TA infused intravenous 20 minites before tourniquet deflation andanother dose 3 hours after operation).Then we detectedthe change in blood routine，D-dimer，FDP and observe the incidence of deep venous thrombosisbetween the two groups.Results The total blood loss was less for patients in the TA group than for the control group：(619±272)mL versus (676±237)mL，respectively，there was no significant difference between the two groups(P＝0.78).However，the total amount of drainage after operation in the two groups was significantly different：(171±152)mL versus (241±174)mL (P＝0.023).There was no significant difference in blood transfusion rate between the two groups：9.9% versus 11.5%(P＝0.23)，and the incidence of DVT was similar for both groups.Conclusion Compared to two intravenous administration，tranexamic acid intravenous drip combined with local joint cavity perfusion has the same efficiency and safety，andhigher clinical operability.

Key words： tranexamic acid total knee arthroplasty blood loss

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