摘要
Abstract
Objective To observe the clinical therapeutic effects of intraoperative intra-articular tranexamic acid combined with"cocktail" therapy on unilateral total knee arthroplasty. Methods Clinical data about 120 patients with terminal osteoarthritis of the knee underwent unilateral total knee arthroplasty in Chinese PLA General Hospital from June 1 in 2014 to June 1 in 2016 were collected. Patients were divided into two groups randomly: experimental group (n=60 knees) received intraoperative intra-articular tranexamic acid combined with "cocktail" therapy in unilateral total knee arthroplasty and control group (n=60 knees) received traditional unilateral total knee arthroplasty. The differences in baseline data between two groups were insignificant (P > 0.05). The differences of perioperative data between two groups were analyzed, including operating time, intraoperative blood loss, tourniquet time, reduction of Hb at 3 d after operation, total blood loss at 3 d after operation, thigh perimeter change rate, crus perimeter change rate. VAS scores were tested at 1, 2, 3, 5, 14 d after operation. HSS scores were tested at 1, 3 months after surgery. Results The differences in operating time, intraoperative blood loss, tourniquet time, thigh perimeter change rate and crus perimeter change rate between two groups were statistically insignificant (P > 0.05). In the observation group, reduction of Hb and total blood loss at 3 d after operation were (23.5±7.2) g/L and (949.3±154.9) ml, less than (26.2±6.9) g/L and ( 1078.1±201.8) ml of the control group, the differences were statistically significant (P < 0.05). In the observation group, the VAS scores at 1, 2, 3 d after surgery were 6.3±1.7, 6.3±1.6 and 5.9±1.5, less than 6.9±1.2, 6.8±0.9 and 6.4±1.0 of the control group, the differences were statistically significant (P < 0.05). The differences of VAS scores at 4, 5, 14 d after surgery between two groups were statistically insignificant (P > 0.05). The differences of HSS scores at 1, 3 months after surgery between two groups were statistically insignificant (P >0.05). Conclusion Intraoperative intra-articular injection of tranexamic acid combined with "cocktail" therapy on unilateral total knee arthroplasty provides advantages in short-term pain relief and less blood loss in perioperative period. It is helpful for the early recovery of patients with unilateral total knee arthroplasty.关键词
关节成形术,置换,膝/氨甲环酸/鸡尾酒疗法/镇痛/失血Key words
arthroplasty/replacement/knee/tranexamic acid/cocktail therapy/analgesia/blood loss分类
医药卫生
