氨甲环酸的不同应用方式在膝关节单髁置换术中失血量的比较

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Abstract Objective To compare the effect of different Tranexamic acid(TXA)administration methods，namely，articular injection(AI)，intravenous injection(II) combined with AI(AI+II)，and no application of tranexamic acid on blood loss(BL)，blood transfusion(BT)，and related complications in patients undergoing unicompartmental knee arthroplasty(UKA).Methods A analysis was conducted on 120 patients，who suffered from unilateral medial compartment knee osteoarthritis and were treated with UKA from September 2018 to March 2020.There were 35 males and 85 females，aged from 51 to 88 years，with an average age of 69 years.They were divided into three groups according to the random number table method：single AI(n＝40)，AI+II(n＝40)，and control group(n＝40).The preoperative and postoperative hemoglobin(Hb) concentrations，Hb decline degree，hematocrit(Hct)test，activated partial thromboplastin time(APTT)，prothrombin time(PT)，and D-dimer were compared among the three groups.Results The postoperative Hb concentration，decrease degree of Hb and postoperative HCT in AI group were (124.8±4.1)g/L，(11.2±3.6)g/L and(39.1±2.4)% respectively，those in AI+II group were (126.0±3.8)g/L，(9.3±4.4)g/L and (39.1±2.2)% respectively，and those in control group were (120.7±4.4)g/L，(15.5±6.1)g/L and (37.8±14.2)% respectively. There was no significant difference between AI group and AI+II Group(P＞0.05).The postoperative Hb concentration and HCT of Ai Group and AI+II group were higher than those of the control group，and the decrease degree of Hb was lower than that of the control group.The difference was statistically significant (P＜0.05).APTT，PT and D-dimer in AI group were (29.7±1.2)s，(12.7±0.8)s and(473.2±74.9)ng/ml respectively，those in AI+II group were(28.6±1.5)s，(12.2±0.5)s and (603.0±148.7)ng/mL respectively，and those in control group were (29.8±1.4)s，(12.9±0.8)s and (486.0±80.0)ng/mL respectively.There was no significant difference between AI group and control group (P＞0.05)；The postoperative APTT and PT in AI group and control group were higher than those in AI+II group，and the postoperative D-dimer was lower than that in AI+II group.The difference was statistically significant (P＜0.05). Conclusion In UKA，compared with AI+II，AI can reduce the risk of lower extremity deep venous thrombosis under the condition of reducing the same blood loss，which is similar to the control group.Therefore，we believe that the application of TXA only through AI in UKA can make the patients have less blood loss and safer in the perioperative period.

Key words： unicompartmental knee arthroplasty tranexamic acid intravenous injection articular injection blood loss

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	Huang Jingxing 1
	2
	Zhang Min 2*
	Pang Junyao 1
	2
	Yan Yubing 1
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Cite this article:

Huang Jingxing 1,2,Zhang Min 2*, et al. Effect of Different Tranexamic Acid Administration Methods on Lowering Blood Loss During Unicompartmental Knee Arthroplasty[J]. sygkzz, 2022, 28(5): 406-411.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I5/406

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