Abstract:

Objective To explore the blood loss and the safety of intra-articular injection of tranexamic acid during unilateral total knee arthroplasty. Methods Sixty patients were enrolled from June 2014 to June 2016, and assigned to two groups, observation group and control group. All patients underwent unilateral total knee arthroplasty （TKA）. In the observation group, had an intra-articular injection of 1 g（20 ml）tranexamic acid and drain clamping for 4 h postoperatively. And in the control group, 20 ml saline was given by intra-articular injection after the surgery and the drain was clamped for 4 hours. Blood loss, drain volume, hidden blood loss and the incidence of deep venous thrombosis between the two groups were recorded. Results Total blood loss, total drainage, cult blood loss were lower in the observation group than that in control group（all P values<0.05）. There were no deep venous thrombosis or other complications in either group. Conclusion Immediately postoperative intra-articular retrograde injection of TA and 4 h of drain-clamping effectively reduced blood loss after TKA.

Key words: total knee arthroplasty, blood loss, intra-articular, venous thromboembolism, tranexamic acid

摘要：

目的 探讨单侧TKA手术中氨甲环酸灌注关节腔对术后出血影响及安全评估。方法 分析我院2014年6月至2016年6月中因膝关节炎行膝关节置换手术的60名患者，在手术过程中使用氨甲环酸灌注关节腔的手术30例，没有使用氨甲环酸注射关节腔的手术30例，分为观察组与对照组两组：观察组，在关闭关节腔后经引流管注射溶有1g氨甲环酸的生理盐水20mL；对照组，关闭关节腔后经引流管灌注20mL生理盐水。手术后闭合引流4h，比较手术后两组患者24h引流量、隐性失血量、总失血量，同时评估手术后两组患者是否出现下肢深静脉血栓。结果 手术后观察组24h引流量、总失血量及隐性失血量均显著少于对照组患者，差异均有统计学意义（P<0.05），两组患者术后均没有发现下肢静脉血栓发生。结论 单侧膝关节置换术后关节腔注射氨甲环酸能减少出血，可能不会增加深静脉血栓风险。

关键词: 氨甲环酸, 关节腔, 膝关节置换, 失血量, 静脉血栓栓塞