Clinical research on tranexamic acid in reducing perioperative blood loss in geriatric patients with hip fracture / 中华老年医学杂志

ABSTRACT

Objective:To investigate the efficacy of intravenous infusion of tranexamic acid(TXA)on perioperative blood loss in geriatric patients with hip fracture.Methods:In this retrospective study, 54 out of 95 patients with hip fracture aged from 65 years to 100 years, treated at the Department of Trauma and Osteology, West China Hospital of Sichuan University from June 2020 to June 2021 were finally enrolled.Their clinical data were collected.All patients underwent closed reduction PFNA surgery.They were divided into three groups: (1)Control group(n=18): intravenous infusion of normal saline at 30 min before surgery; (2)Single dose group(n=18): TXA(25 mg/kg)was intravenously injected at 30min before surgery; (3)multiple dose group(n=18): 25 mg/kg of TXA was intravenously injected at 30 min before surgery and 15 mg/kg injected again at 3 h and 6 h after surgery.Total blood loss and the incidence of postoperative deep venous thrombosis among 3 group patients were compared.Results:There were no statistically significant differences in gender, age, preoperative platelets, preoperative activated partial thrombin time and preoperative prothrombin time among control group, single dose group and multiple dose group(all P>0.05). Perioperative blood loss was estimated to be 620(330, 1080)ml, 380(270, 490)ml and 520(190, 750)ml in the control group, single dose group and multiple dose group, respectively, with statistical significance( H=8.666, P<0.05). Total blood loss in single dose group was less than in both control( P<0.05, with statistical significance)and in multiple groups( P>0.05, without statistical significance), and total blood loss in multiple dose group was lower than in control( P>0.05, without statistical significance), and higher than in single dose group( P>0.05, without statistical significance). Color ultrasonography was performed on the 1 st and 7 th day after surgery in 3 groups, and no deep venous thrombosis or pulmonary embolism was found in all groups. Conclusions:Intravenous infusion of TXA at half an hour before surgery can effectively reduce the total peri-operative blood loss without increasing the risk of thrombosis.A multiple preoperative intravenous drip of TXA should be cautious as compared with a single preoperative intravenous drip of TXA.