APPLICATION OF TRANEXAMIC ACID INTRAVENOUS DRIP BEFORE INTERNAL FIXATION IN THE TREATMENT OF ELDERLY PATIENTS WITH UNSTABLE INTERTROCHANTERIC FRACTURE

Shufeng Huang^#, Wenlin Hu^#, Zheyuan Shen^#, Minli Wang^*

Department of Orthopedics, The First People’s Hospital of Huzhou,First Affiliated Hospital of Huzhou Teachers College,Huzhou, Zhejiang, 313000, PR China

Objective: To investigate the application effect of tranexamic acid intravenous drip before internal fixation in elderly patients with unstable intertrochanteric fracture. 

Methods: A total of 136 elderly patients with unstable intertrochanteric fracture admitted to our hospital from January 2018 to June 2020 were chosen and divided into two groups by the random number table, with each group including 78 cases. The experimental group was given tranexamic acid intra-venous injection before operation, while the control group was not given tranexamic acid intravenous injection before operation. The baseline clinical data, perioperative blood transfusion rate, perioper-ative blood loss volume, postoperative drainage volume, preoperative and postoperative laboratory indicators and safety indicators of 2 groups were compared. 

Results: There was no significant difference in baseline clinical data between 2 groups (P>0.05). The perioperative blood transfusion rate, total blood loss volume and hidden blood loss volume of experimental group were significantly less than those of control group (P<0.05). There was no sig-nificant difference in the volume of explicit blood loss and postoperative drainage between 2 groups (P>0.05). There was no significant difference in levels of Hb and HCT between 2 groups before and at 7d after operation (P>0.05). The levels of Hb and HCT of experimental group were significantly higher than those of control group at 1d, 3d and 5d after operation (P<0.05). There was no significant dif-ference in the incidence of intramuscular venous thrombosis between 2 groups (P>0.05). No severe thrombus-related complications such as deep venous thrombosis (DVT), pulmonary embolism (PE) and ischemic stroke occurred. 

Conclusion: Tranexamic acid intravenous drip before internal fixation in the treatment of elderly patients with unstable intertrochanteric fracture can effectively control the perioperative blood loss volume, especially the hidden blood loss, with good safety and clinical application value.