关键词: 胫骨平台骨折, 氨甲环酸, 失血量, 炎症因子

Abstract: Objective To investigate the effect of multiaxial locking plate internal fixation combined with tranexamic acid on postoperative blood loss and serum inflammatory factors of Schatzker type V and VI tibial plateau fractures. Methods From September 2019 to December 2020,100 patients with complex tibial plateau fractures were randomly divided into group A Group B was treated with internal fixation with multi axis locking plate.Group A was given 15 mg/kg normal saline before skin incision,and group B was given 15 mg/kg intravenous tranexamic acid.The perioperative blood loss and blood transfusion of the two groups were compared,The perioperative blood loss and blood transfusion of the two groups were compared,the levels of Hemoglobin(HB),D-Dimer(D-dimer) and fibrin degradation product(FDP) were compared 24 and 72 hours after operation.the levels of Serum interleukin-1(IL-1),tumor necrosis factor-α(TNF-α) and matrix metalloproteinase-2(MMP-3) were compared before and after operation. Results The blood transfusion rate of group B was 21.28%,which was lower than that of group A 41.51%( P ＜0.05).The level of Hb in group B was higher than that in group A[(114.83±11.94)g/L VS (104.57±10.28)g/L],the levels of D-dimer in group B were lower than those in group A[(4.12±0.75)mg/L,(5.17± 1.30)mg/L](all P＜0.05).7 days after operation,the levels of serum IL-1,TNF-α and MMP-3 in group B[24.22±6.16)ng/L,(42.30±6.62)ng/L,(11.57±2.13)g/L] were lower than that in the group A[(30.95±5.50)ng/L,(56.09±6.50)ng/L,(15.63±2.41)g/L](all  P ＜0.05). Conclusion The application of multi axis locking plate internal fixation combined with tranexamic acid in Schatzker type Ⅴ and Ⅵ tibial plateau fractures can effectively reduce the postoperative blood loss,reduce the postoperative HB loss,and promote the rapid recovery of postoperative joint function.

Key words: tibial plateau fracture, tranexamic acid, blood loss, inflammatory factors