目的明确单剂量氨甲环酸（TXA）关节腔内注射和自体血回吸收器应用对全膝关节置换（TKA）术后失血的影响。方法回顾分析采用TKA治疗的内翻型膝关节骨性关节炎患者124例（124膝），男24例，女100例，平均年龄（65.03±6.84）岁。根据TKA控制术后失血的方法将所有患者分为TXA注射组（实验组，49例）和自体血回吸收器应用组（对照组，75例）。分析TKA术后血常规的变化、失血量和输血情况。结果术后7 d实验组输血率为10.20%（5/49），对照组为17.33%（13/75），差异无统计学意义（P＞0.05）。RBC、Hb、HCT在组间、时间和交互效应差异均有统计学意义（均P＜0.01）。术后1、3、7 d，实验组RBC、Hb、HCT均高于对照组（均P＜0.05）。术后1、3 d实验组总失血量小于对照组，术后7 d，2组失血量比较差异无统计学意义（P＞0.05）。结论关节腔内单剂TXA注射对于TKA术后止血安全有效。%Objective To compare the efficiency of intra-articular injection of tranexamic acid (TXA) and autolo-gous transfusion drain on the blood loss after total knee arthroplasty (TKA). Methods A total of 124 patients (124 knees) with varus knee osteoarthritis, who were performed TKA,were retrospectively analyzed. Patients included 24 males and 100 females. The mean age was(65.03±6.84)years. Due to the blood loss control method, patients were divided into two groups including TXA application group (test group, n=49) and autologous transfusion drain group (control group, n=75). The data of blood routine examination, blood loss and blood transfusion after TKA were analyzed. Results The blood transfusion rates were 10.20%(5/49) in test group and 17.33%(13/75) in control group 7 days after TKA surgery. There was no signifi-cant difference between two groups (P>0.05). There were significant differences in red blood cell (RBC), hemoglobin (Hb) and haematocrit (HCT) between groups and effects of interaction in the two groups (P<0.01). There were significantly higher values of RBC, Hb and HCT at 1, 3 and 7 days after surgery in test group than those of control group (P<0.05).The total blood loss 1 and 3 days after TKA was significantly lower in test group than that of control group (P<0.05). There was no sig-nificant difference in the blood loss 7 days after surgery between two groups (P>0.05). Conclusion The single dose intra-articular injection of tranexamic acid is a safe and effective procedure for hemostasis after TKA.
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