氨甲环酸在人工关节外科领域的应用

Tranexamic acid （ TXA ） is economical and safe, with good hemostatic effects in joint surgery. The intravenous route is most commonly used. TXA can also be administrated orally or intra-articularly but not intrathecally or intra-cerebrally. Better hemostatic effects can be achieved both in spinal surgery and total hip arthroplasty （ THA ） with the use of TXA. TXA is generally injected intra-articularly in total knee arthroplasty （ TKA ） before the tourniquet was released and after the capsule was sutured. The patients who underwent TKA were divided into 2 groups, including one group receiving 1.5% TXA intra-articularly and the other group receiving 3.0% TXA intra-articularly. The postoperative blood loss volume was 1295 ml in the 1.5% TXA group, and 1208 ml in the 3.0% TXA group. Statistically signiifcant differences were observed between the 2 groups, and the patients receiving more TXA had less blood loss. Only the articular cavity is affected with the intra-articular administration of TXA. Such advantages as minimal systemic absorption, less intra-articular bleeding and reduced risk of deep venous thrombosis （ DVT ） and pulmonary embolism （ PE ） can be found with the intra-articular administration of TXA when compared with the intravenous administration. The intra-articular administration of TXA is superior to the intravenous administration. （ 1 ） Potential complications related to the intravenous administration of TXA can be avoided or decreased, particularly in high-risk patients, such as the patients with cardiovascular diseases, venous thromboembolism, renal dysfunction and so on. （ 2 ） The blood loss, blood transfusion and transfusion rate after TKA can be reduced with the intra-articular administration of TXA. TXA is contraindicated in the patients with a history of arterial or venous thrombosis, hematological system diseases, acute renal failure, seizures and/or hypersensitivity. Postoperative hemorrhage is caused by many factors, and the physicians should take comprehensive

Application of tranexamic acid in artiifcial joint surgery