INTRODUCTION This study aimed to investigate the effect of tranexamic acid (TXA) with sequential routine anticoagulation on postoperative symptomatic venous thromboembolism (VTE) in patients undergoing primary total knee arthroplasty (TKA). MATERIAL AND METHODS This was a prospective study with randomized trials. From January 2013 to May 2015, 1880 patients undergoing primary TKA were enrolled in this study. Seven hundred and twenty patients who received TXA injection were included in the TXA group while 1160 patients who received placebo injection were included in the control group. Patients in the TXA group were treated with intravenous TXA or topical intravenous TXA, and all received sequential routine anticoagulation 12 h after the operation. We extracted data of patients' sex, age, primary diagnoses, and comorbidities that could potentially affect the prevalence rate of VTE. To discuss the risk factors of symbolic VTE, comparisons were made within the TXA group between patients with symbolic VTE and non-symbolic VTE. Logistic regression analysis was performed to analyze the concurrent effects of various factors on the prevalence rate of postoperative VTE. RESULTS Thigh perimeter was not closely associated with TXA injection. Within the TXA group, 24 (3.3%) patients had perioperative symptomatic VTE, 16 (2.2%) deep vein thrombosis (DVT) and 8 (1.1%) pulmonary embolism. High body mass index (BMI), low fibrinogen (Fbg) and simultaneous bilateral TKA were significant risk factors in both univariate analysis and multivariate analysis. CONCLUSIONS Increased BMI, low Fbg, and simultaneous bilateral TKA could act as risk factors for postoperative symptomatic VTE treated with TXA.

中文翻译：

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氨甲环酸对初次全膝关节置换术患者症状性静脉血栓栓塞的影响。

引言 本研究旨在探讨氨甲环酸 (TXA) 与序贯常规抗凝治疗对初次全膝关节置换术 (TKA) 患者术后症状性静脉血栓栓塞 (VTE) 的影响。材料和方法 这是一项随机试验的前瞻性研究。从 2013 年 1 月到 2015 年 5 月，本研究招募了 1880 名接受原发性 TKA 的患者。TXA组有720名接受TXA注射的患者，对照组有1160名接受安慰剂注射的患者。氨甲环酸组患者给予静脉氨甲环酸治疗或局部静脉氨甲环酸治疗，术后12 h均接受序贯常规抗凝治疗。我们提取了患者的性别、年龄、主要诊断、以及可能影响 VTE 患病率的合并症。为了讨论象征性 VTE 的危险因素，我们在 TXA 组内对象征性 VTE 和非象征性 VTE 患者进行了比较。采用Logistic回归分析分析各因素对术后VTE患病率的影响。结果 大腿周长与 TXA 注射没有密切相关。在 TXA 组中，24 例 (3.3%) 患者出现围手术期症状性 VTE，16 例 (2.2%) 深静脉血栓形成 (DVT) 和 8 例 (1.1%) 肺栓塞。高体重指数（BMI）、低纤维蛋白原（Fbg）和同时双侧TKA是单变量分析和多变量分析的重要危险因素。结论 BMI 升高、Fbg 降低、