A controlled study of intravenous tranexamic acid infusion to reduce latent blood loss during extended PFNA internal fixation for femoral subtrochanteric fractures
Objective To observe the effect of intravenous tranatemic acid on postoperative blood loss in patients undergoing extended PFNA fixation for femoral subtrochanteric fracture. Methods From January 2017 to July 2018, 67 patients with femoral subtrochanteric fracture who received extended PFNA fixation treatment in our hospital were selected and randomly divided into experimental group (tranexamic acid intravenous injection, 37 cases) and control group (normal saline intravenous injection, 30 cases). Tranexamic acid 1 g (200 mL) or normal saline (200 mL) were given intravenously 15 min before incision, 3 h and 6 h after operation, respectively. Postoperative12 h, 24 h conventional anticoagulant treatment to prevent lower limb venous thrombosis. The intraoperative blood loss, the changes of hemoglobin (Hb) and hematocrit (HCT) on the 1st and 3rd day after surgery, the drainage volume on the 2nd day after surgery, the recessive blood loss on the 3rd day after surgery, the ratio of postoperative blood transfusion, and the incidence of early postoperative complications were compared between the two groups. Results The drainage volume of the experimental group was (30.3±26.4) mL and that of the control group was (81.3±44.4) mL, the difference was statistically significant (P＜0.05). Hb was (100.3±16.7) g/L in the experimental group and (81.3±24.4) g/L in the control group on the 1st day after surgery, and the difference was statistically significant (P＜0.05). Hb was (101.3±11.9) g/L in the experimental group and (100.3±14.4) g/L in the control group on the 3rd day after surgery, the difference was not statistically significant (P＞0.05). The HCT of the experimental group was 30.3±6.7 on the 1st day after surgery, and that of the control group was 25.3±4.4, the difference was statistically significant (P＜0.05); the HCT of the experimental group was 30.3±4.9 on the 3rd day after surgery, and that of the control group was 29.3±3.4, the difference was statistically significant (P＜0.05). The latent blood loss on the third day after surgery was (201.3±101.9) mL in the experimental group and (301.3±211.9) mL in the control group, with statistical significance (P＜0.05). The postoperative blood transfusion rate was 0.00％ in the experimental group and 16.67％ in the control group. There was no significant difference in the incidence of early complications between the two groups (P＞0.05). Conclusion Intravenous tranatemic acid infusion can reduce hidden blood loss during PFNA internal fixation for extended femoral subtrochanteric fractures, reduce postoperative blood transfusion rate, and thus reduce the incidence of related complications.
万方数据
