氨甲环酸对青少年特发性脊柱侧弯后路矫形术患者围术期出血的影响

Effect of tranexamic acid on blood loss in adolescents undergoing orthopedic surgery for idiopathic scoliosis

目的探讨氨甲环酸(TXA)对青少年特发性脊柱侧弯后路矫形术患者围术期出血的影响。方法青少年特发性脊柱侧弯患者40例,随机均分为两组:A组切皮前静脉滴注TXA 15mg/kg,术中10mg·kg-1·h-1维持至术毕;B组输注等量生理盐水。记录两组术中出血量、术后24-h引流量、围术期自体输血量和异体输血量,并观察术后深静脉血栓等并发症发生情况。结果 A组术中出血量和术后24-h引流量均少于B组[(514±265)ml vs.(724±278)ml和(260±95)ml vs.(425±115)ml](P<0.05和P<0.01),围术期自体输血量和异体输血量也少于B组[(115±56)ml vs.(205±73)ml和(273±95)ml vs.(350±110)ml](P<0.05和P<0.01)。两组术后均无深静脉血栓等并发症发生。结论术中应用TXA可减少青少年特发性脊柱侧弯后路矫形术患者围术期出血量和输血量,无深静脉血栓等并发症。

Objective To investigate the effect of tranexamic acid（TXA）on blood loss in the adolescents undergoing orthopedic surgery for idiopathic scoliosis.Methods Forty adolescents with idiopathic scoliosis scheduled for selective posterior spinal fusion were equally randomized into two groups of A（injected TXA 15 mg/kg before incision and infused TXA 10 mg·kg-1·h-1 during surgery）and B（given 0.9% saline as the control）.Blood loss in operation and the drainage volume in24 hafter operation were recorded.Cell salvage transfusion and allogenic transfusion were recorded.Deep venous thrombosis and related complications were observed.Results The blood loss and 24-h drainage after operation were remarkably less in group A than those in group B[（514±265）ml vs.（724±278）ml and（260±95）ml vs.（425±115）ml]（P〈0.05 and P〈0.01）.So did the volumes of cell salvage and allogenic blood transfusion[（115±56）ml vs.（205±73）ml and（273±95）ml vs.（350±110）ml]（P〈0.05 and P〈0.01）.There were no deep venous thrombosis and other related complications in both groups.Conclusion Intraoperative administration of TXA can effectively reduce surgical blood loss and requirements for transfusion in the adolescents undergoing orthopedic surgery for idiopathic scoliosis.