To investigate the application value of tranexamic acid (TXA) in reducing perioperative blood loss of obese patients undergoing primary total hip arthroplasty (THA).

Clinical data of 80 obese patients undergoing primary THA because of ischemic necrosis of femoral head in Department Two of Orthopedics, Wuyi Traditional Chinese Medicine Hospital of Jiangmen from November 2014 to June 2015 were retrospectively studied. The informed consents of all women were obtained and the local ethical committee approval had been received. According to whether TXA was used in perioperative period, those patients were divided into the TXA group and the non-TXA group. Forty patients were included into the TXA group, of whom 18 were males and 22 were females with an average age of (59±4) years old. Forty patients were included into the non-TXA group, of whom 26 were males and 14 were females with an average age of (58±3) years old. TXA was used in the TXA group patients: they were given 20 mg/kg TXA by intravenous administration 15 minutes before skin incision, and 3 g TXA which was diluted into 50 ml with normal saline and then retrograde injected through drainage tube before skin suture. The patients in the non-TXA group were given normal saline of the same dose instead. The indexes of body weight, height, intraoperative blood loss, postoperative suction drainage, rate of blood transfusion, blood routine examination before and 1 and 3 d after operation, total blood loss and hidden blood loss were compared between the two groups. Comparisons of the data were conducted using t test and χ² test.

The total blood loss, postoperative suction drainage, hidden blood loss and rate of blood transfusion of the patients in the TXA group were (667±219) ml, (247±129) ml, (268±192) ml and 22.5% (9/40) respectively, which were significantly lower than (1217±493) ml, (519±252) ml, (591±298) ml and 67.5% (27/40) of those patients in the non-TXA group (t=6.448, 6.077, 5.763, 16.364, P<0.05); the hemoglobin levels of both the two groups were lower than those before surgery respectively, but the hemoglobin levels of the patients in the TXA group were (103±16) and (95±12) g/L at 1 and 3 d after operation respectively, which were significantly higher than (92±15) and (84±10) g/L of the patients in the non-TXA group (t=3.438, 4.436, P<0.05); there was no statistical difference in the rate of deep venous thrombosis between the two groups (χ²=0.353, P>0.05).

TXA can reduce perioperative blood loss of obese patients undergoing primary THA, and do not increase the risk of deep vein thrombosis and pulmonary embolism, so it’s worthy of clinical promotion and application.