关键词: 骨关节炎, 膝；关节成形术, 置换, 膝；氨甲环酸；出血, 手术

Abstract: Objective　To investigate the effect of tranexamic acid（TXA） on intraoperative and postoperative blood loss in patients with knee osteoarthritis undergoing total knee arthroplasty（TKA）.Methods　We enrolled 98 cases of knee osteoarthritis treated by unilateral TKA from Affiliated Hospital of Logistics University of Chinese People's Armed Police Force，including 52 received the surgery between June and December 2015（control group） ，and 46 received the surgery between March and September 2016（TXA group）.The control group did not use TXA，while the TXA group received TXA intraoperatively and postoperatively via various ways（intravenous drip of TXA 1 g at 10 min before making a skin incision，intra-articular injection of TXA 1 g via a draining tube when the suturing was completed，and intravenous drip of TXA 1 g at 6，12 and 24 h after TKA）.We analyzed both groups' visible and hidden blood loss，rate of receiving blood transfusion and the incidence of lower extremity deep vein thrombosis（DVT） .Results　Compared with the control group，TXA group showed less visible blood loss〔（224±59） ml vs（361±70） ml〕，hidden blood loss〔（486±69）ml vs（633±79）ml〕 as well as lower rate of receiving blood transfusion〔6.5%（3/46） vs 46.2%（24/52）〕（P<0.05）.However，the incidence of lower extremity DVT in the TXA group and the control group was 4.3%（2/46） and 7.7%（4/52），respectively，with no significant difference（P>0.05）.Conclusion　Local application combined with intravenous drip of TXA can reduce intraoperative and postoperative blood loss and rate of receiving blood transfusion without increasing the risk of lower extremity DVT in patients with knee osteoarthritis undergoing TKA.

Key words: Osteoarthritis, knee；Arthroplasty, replacement, knee；Tranexamic acid；Blood loss, surgical