氨甲环酸对老年脊柱手术患者的血液保护效果分析

The analysis of Tranexamic acid in elderly patients with spinal operation blood protective

目的评价氨甲环酸对老年脊柱手术患者的血液保护效果。方法择期脊柱手术患者 80 例,性别不限,年龄65～70 岁,体重指数16～22kg/m2,ASA 分级Ⅱ或Ⅲ级,采用随机数字表法,将其分为 2 组,各 40 例:对照组(C组)和氨甲环酸组(T组)。切皮前 T 组经 15min 静脉输注氨甲环酸 15mg/kg,C组给予等容量生理盐水。术中监测 Hb、Plt、PT 和 APTT 指导输血。记录术中出血量、术后 12h 和 48h 出血量,术中、术后异体血输注情况。记录围术期并发症的发生情况。结果与C组比较,T 组术中出血量、术后出血量、异体红细胞使用率降低(P<0.05),两组未见术后并发症的发生。结论氨甲环酸对老年脊柱手术患者具有一定血液保护效应。

Objective To evaluate the effect of tranexamic acid（TXA） in elderly patients with spinal operation blood protective.Methods 80 patients ASAⅡor Ⅲ,6～7 were randomly divided into 2 groups（n=40 each）：control group（group C）and tranexamic acid group（group T）.Group T receive 15mg/kg body weight of TXA,group C receive an equivalent volume of saline intravenously before the skin incision.Intraoperative monitor the Hb,Plt,PT and APTT for instruct transfusion of blood.To record the amount of bleeding both intrapoerative and 12h or 48h later postoperative,to record the situation of allogeneic tranfusion on postoperative and intraoperative.To record perioperative complications.Results Compared with group C,Though intraoperative blood loss in the T group was significantly reduced,especially the postoperative blood loss during the first 12h was reduced.The total blood volumes of transfusion and odds ratio of transfussion rate were reduced,respectively.No thromboembolic events or complications occurred in either group.Conclusion TXA can demonstrate certain effect on blood conservation in elderly patients undergoing spinal surgery.