Novosti
Khirurgii

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Year 2017 Vol. 25 No 4

TRAUMATOLOGY AND ORTHOPEDICS

K.B. BALABOSHKA, Y.K. KHADZKOU

BLOOD-SAVING EFFECT OF AMINOCAPROIC ACID IN TOTAL KNEE JOINT REPLACEMENT

EE “Vitebsk State Medical University”,
Vitebsk,
The Republic of Belarus

Objectives. To evaluate the effectiveness of aminocaproic acid for reducing the perioperative blood loss in primary total knee joint replacement.
Methods. The patients (n=82) with the total knee joint replacement were included in the study. In the study group (n=42) parenteral administration of aminocaproic acid (100 mg/kg, 5% solution) was administered before applying the tourniquet, with repeated administration of the calculated dose of the drug in 4 hours. Patients of the control group (n=40) did not receive aminocaproic acid. The following indicators were compared: hemoglobin concentration, erythrocyte count, hematocrit volume of red blood cells prior to surgery and in the postoperative period (5 days). Drainage blood was recorded within 24 hours after the operation.
Results. In the study group blood loss/drainage volume was significantly reduced (300, 200-350 ml (Me 25%, 75%)) compared to the control group (600, 525-725 ml (Me, 25%, 75%)), p<0,001. In the postoperative period the drainage blood loss and calculated blood loss volumes were significantly higher for the control group (mean value of blood indicators in the study group: hemoglobin 118, 105 – 124 g/l, erythrocytes 3,95, 3,7 – 4,2×1012/l, hematocrit 36,55, 32,8 – 39,6 (Me 25%, 75%) and mean value of blood indicators: hemoglobin 105,5, 95 – 119 g/l, erythrocytes 3,45, 3,1 – 3,9×1012/ l, hematocrit 30, 95, 29,65 – 34,05 (Me, 25%, 75%)), p<0,05, respectively. In the control group, 11 patients (27,5%) were subjected to massive red blood cell transfusion. Donor blood component transfusion was not performed in the patients of the study group. No complication associated with aminocaproic acid application was registered.
Conclusion. The use of aminocaproic acid has proved to be an efficient and practical method of treatment patients with degenerative dystrophic diseases of the knee joint by eliminating the need for surgical blood transfusion in the total knee joint replacement, as well as by decreasing reimbursement for surgical procedures.

Keywords: knee joint replacement, blood loss, fibrinolysis inhibitors, aminocaproic acid, blood transfusion, economic costs, surgical intervention
p. 389-393 of the original issue
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Address for correspondence:
210023, Republic of Belarus,
Vitebsk, Frunze ave., 27,
Vitebsk State Medical University,
department of traumatology,
orthopedics and military field surgery,
tel.office: +375 29 654-45-99,
e-mail: bkb@tut.by,
Konstantin B. Balaboshka
Information about the authors:
Balaboshka K.B. PhD, Ass.Professor, Head of department of traumatology, orthopedics and military field surgery, EE “Vitebsk State Medical University”.
Khadzkou Y.K. teacher trainee of department of traumatology, orthopedics and military field surgery, EE “Vitebsk State Medical University”.
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