Abstract：
OBJECTIVE: Our aim was to compare the effects of intraarticular and intravenous (IV) tranexemic acid (TXA) application on bleeding and complication rates in patients who underwent total knee arthroplasty (TKA).
METHODS: Between 2017 and 2021, 406 patients who underwent TKA with 2 g of IV TXA and retrograde 1.5 g of TXA applied through the drain were included in the study. Of the patients, 206 were in the IV TXA group. Preoperative and postoperative hemoglobin levels, drain output, BMI, ASA score, blood loss, and the number of transfused patients were recorded. Complications such as symptomatic venous thromboembolism were also recorded.
RESULTS: There was no significant difference between the two groups in terms of age, sex, American Society of Anesthesiologists (ASA) score, or BMI (p = 0.68, 0.54, 0.28, 0.45). Total drain output and blood loss were significantly higher in the IV TXA group than in the intraarticular TXA group (p < 0.0001, p < 0.0001). Eighteen patients in the IV TXA group and 1 patient in the intraarticular TXA group received a blood transfusion (p < 0.0001). There was no difference between the two groups in terms of preoperative hemoglobin or platelet count (p = 0.24). However, postoperative hemoglobin level was higher in the patients who received intraarticular TXA (p=0.0005). More thromboembolism events were seen in the IV TXA group (p < 0.0001).
CONCLUSIONS: Intraarticular TXA application reduces blood loss more than IV application, reduces the blood transfusion rate, and causes fewer complications.
BACKGROUND: tranexemic acid, total knee arthroplasty, intraarticular injection, blood loss, blood transfusion.
METHODS: Between 2017 and 2021, 406 patients who underwent TKA with 2 g of IV TXA and retrograde 1.5 g of TXA applied through the drain were included in the study. Of the patients, 206 were in the IV TXA group. Preoperative and postoperative hemoglobin levels, drain output, BMI, ASA score, blood loss, and the number of transfused patients were recorded. Complications such as symptomatic venous thromboembolism were also recorded.
RESULTS: There was no significant difference between the two groups in terms of age, sex, American Society of Anesthesiologists (ASA) score, or BMI (p = 0.68, 0.54, 0.28, 0.45). Total drain output and blood loss were significantly higher in the IV TXA group than in the intraarticular TXA group (p < 0.0001, p < 0.0001). Eighteen patients in the IV TXA group and 1 patient in the intraarticular TXA group received a blood transfusion (p < 0.0001). There was no difference between the two groups in terms of preoperative hemoglobin or platelet count (p = 0.24). However, postoperative hemoglobin level was higher in the patients who received intraarticular TXA (p=0.0005). More thromboembolism events were seen in the IV TXA group (p < 0.0001).
CONCLUSIONS: Intraarticular TXA application reduces blood loss more than IV application, reduces the blood transfusion rate, and causes fewer complications.
BACKGROUND: tranexemic acid, total knee arthroplasty, intraarticular injection, blood loss, blood transfusion.
摘要：
目的：我们的目的是比较全膝关节置换术（TKA）患者关节腔内和静脉内（IV）氨甲环酸（TXA）应用对出血和并发症发生率的影响。
方法：在2017年至2021年之间，406例患者接受了通过引流管应用2gIVTXA和逆行1.5gTXA的TKA。在患者中，TXAIV组206例。术前、术后血红蛋白水平,漏极输出,BMI,ASA得分,失血,并记录输血患者的数量。还记录了并发症，例如有症状的静脉血栓栓塞。
结果：两组在年龄方面没有显着差异，性别,美国麻醉医师协会（ASA）评分，或BMI（p=0.68，0.54，0.28，0.45）。静脉TXA组的总引流输出量和失血量明显高于关节内TXA组（p<0.0001，p<0.0001）。IVTXA组18例患者和关节内TXA组1例患者接受了输血(p<0.0001)。两组术前血红蛋白或血小板计数无差异（p=0.24）。然而,接受关节内TXA的患者术后血红蛋白水平较高(p=0.0005).在静脉TXA组中观察到更多的血栓栓塞事件(p<0.0001)。
结论：关节内应用TXA比静脉内应用更能减少失血，降低输血率,并减少并发症。
背景：抗转基因酸，全膝关节置换术,关节内注射,失血,输血.
方法：在2017年至2021年之间，406例患者接受了通过引流管应用2gIVTXA和逆行1.5gTXA的TKA。在患者中，TXAIV组206例。术前、术后血红蛋白水平,漏极输出,BMI,ASA得分,失血,并记录输血患者的数量。还记录了并发症，例如有症状的静脉血栓栓塞。
结果：两组在年龄方面没有显着差异，性别,美国麻醉医师协会（ASA）评分，或BMI（p=0.68，0.54，0.28，0.45）。静脉TXA组的总引流输出量和失血量明显高于关节内TXA组（p<0.0001，p<0.0001）。IVTXA组18例患者和关节内TXA组1例患者接受了输血(p<0.0001)。两组术前血红蛋白或血小板计数无差异（p=0.24）。然而,接受关节内TXA的患者术后血红蛋白水平较高(p=0.0005).在静脉TXA组中观察到更多的血栓栓塞事件(p<0.0001)。
结论：关节内应用TXA比静脉内应用更能减少失血，降低输血率,并减少并发症。
背景：抗转基因酸，全膝关节置换术,关节内注射,失血,输血.
