Objective To investigate the effect of tranexamic acid and different anticoagulants on blood loss during the perioperative period of total knee arthroplasty. Methods A total of 158 patients with knee osteoarthritis who underwent total knee arthroplasty (TKA) from October 2014 to October 2019 and met the criteria were enrolled. According to different tranexamic acid injection methods and postoperative use of different anticoagulants, they were divided into four group: Group A: intraoperative intravenous injection of tranexamic acid + postoperative rivaroxaban anticoagulation; Group B: intraoperative intravenous injection of tranexamic acid + postoperative enoxaparin anticoagulation; Group C: intraoperative vein injection + local injection of tranexamic acid + postoperative rivaroxaban anticoagulation; Group D: intraoperative intravenous injection + local injection of tranexamic acid + postoperative enoxaparin anticoagulation. The preoperative preparations, intraoperative and postoperative treatments of the patients in each group were the same. The general information, intraoperative conditions, blood loss, blood coagulation function, blood transfusion and incidence of perioperative adverse events were compared in the four groups. Results The combined use of tranexamic acid could further reduce total bleeding, overt bleeding, blood transfusion rate and plasma D dimerization body (P<0.05). After the use of rivaroxaban for anticoagulation, the bleeding volume, blood transfusion rate and perioperative adverse event rate were equivalent to enoxaparin. Conclusions The application of intravenous tranexamic acid combined with local injection during TKA can further effectively reduce the blood loss, transfusion rate and Plasma D dimer during the perioperative period. Rivaroxaban or enoxaparin is used for anticoagulation after operation, there is no significant difference in the blood loss and the incidence rate of perioperative adverse events.
Key words
Total knee arthroplasty; /
/
Tranexamic acid; /
Anticoagulant drugs; /
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Perioperative period; /
Blood loss
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