OBJECTIVE:To observe the effects of different regimens of tranexamic acid on perioperative bleeding and postoper-ative compliance of simultaneous bilateral total knee arthroplasty(TKA). METHODS:A total of 70 patients undergoing simultane-ous bilateral TKA in our hospital were randomly divided into control group and observation group,with 35 cases in each group. Control group was given Tranexamic acid injection 15 mg/kg 30 min before surgery. Observation group was given Tranexamic acid injection 15 mg/kg,30 min before surgery and 30 min before suturing incision. The operation duration,total blood loss,intraopera-tive blood loss,postoperative drainage as well as the levels of FIB,PT,APTT before trectment and 3 d after surgery,the occur-rence of postoperative compliance and ADR were observed and compared between 2 groups. RESULTS:There was no statistical significance in operation duration,intraoperative blood loss and rate of ADR between 2 groups (P>0.05). The total blood loss, postoperative drainage and the incidence of complications of observation group were significantly lower than those of control group,with statistical significance(P0.05). CONCLUSIONS:The application of tranexamic acid 30 min before simultaneous bilateral TKA and 30 min before the end of surgery can reduce perioperative bleeding and postoperative venous thromboembolism with good safety.%目的:观察氨甲环酸不同用药方案对同期双侧全膝关节置换术(TKA)围术期患者出血及术后并发症的影响.方法:选择我院以行同期双侧TKA的患者70例,随机分为对照组(n=35)和观察组(n=35).对照组患者术前30 min给予氨甲环酸注射液15 mg/kg,静脉滴注,观察组患者术前30 min、缝合切口前30 min分别给予氨甲环酸注射液15 mg/kg,静脉滴注.观察并比较两组患者手术时间、总失血量、术中失血量、术后引流量、治疗前和术后3 d纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平、术后并发症发生情况和不良反应发生情况.结果:两组患者手术时间、术中失血量和不良反应发生率比较,差异无统计学意义(P>0.05);观察组患者总失血量、术后引流量显著少于对照组,术后并发症发生率显著低于对照组,差异均有统计学意义(P0.05).结论:同期双侧TKA患者术前30 min、手术结束前30 min静脉滴注氨甲环酸注射液能降低围术期出血,减少术后并发症的发生,安全性较好.
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