ÖZET
Amaç:
Turnike ve dren kullanmadan primer total diz artroplastisi (TDA) geçiren hastalarda traneksamik asit (TXA) uygulama yolunun tahmini kan kaybı (EBL) üzerindeki etkisini değerlendirdik.
Yöntemler:
Aralık 2012-Şubat 2016 tarihleri arasında TXA kullanılarak primer TDA uygulanan 103 hasta retrospektif olarak incelendi. Hastalar TXA kullanım yoluna göre üç gruba ayrıldı: grup I, 2 g intravenöz (IV; n=25); grup II, 2 g intraartiküler (IA, n=25); ve grup III, 1 g IV ve 1 g IA kombine kullanım (n=53). Vücut kitle endeksleri, platalet sayımı, hemoglobin, hematokrit seviyeleri, protrombin zamanı (PT), parsiyel tromboplastin zamanı (PTT) ve internationel normalized ratio (INR) preop, postop 1. ve 7. günde değerlendirdik. EBL, meunier formülü kullanılarak hesaplandı.
Bulgular:
İlk gün I ila III. grupların ortalama EBL’leri sırasıyla 286,3±130,15 mL, 342,7±177,87 mL ve 379,7±228,85 mL idi ve istatistiksel olarak farklı değildi (p=0,152). Ameliyat sonrası 7. günde 823±625,75 mL, 1175,1±980,6 mL ve 1092,2-766,7 mL (p=0,250) ameliyattan sonraki ilk 90 gün boyunca herhangi bir semptomatik tromboembolik komplikasyon, gecikmiş kanama veya cerrahi bölge veya periprostetik enfeksiyon görülmedi.
Sonuç:
IV, IA veya TXA’nın kombine kullanımları, turnike ve drenaj olmadan primer TDA’da kan kaybını ve transfüzyon gereksinimlerini azaltmak için etkili ve güvenlidir.
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