氨甲环酸预防性用药用于颈椎手术患者血液保护的效应

Blood-saving effect of prophylactic tranexamic acid use in patients undergoing cervical spine surgery

【摘要】目的评价氨甲环酸颅防性用药对颈椎手术患者血液保护的效应。方法择期行颈后路椎板切除减压融合内固定术患行100例，性别不限，年龄55～75岁，BMI 19．0～25．0kg／m2，ASA分级Ⅰ或Ⅱ级，采用随机数字表法分为2组（n=50）;氨甲环酸组（TXA组）和生理盐水组（NS组）。TXA组于切皮前30min静脉注射氨甲环酸15mg／kg；NS组给予等容量生理盐水、于术前、术后第1、3及5天测定Hb。

[ Abstract] Objective To evaluate the blood-saving effect of prophylactic tranexamie acid （TXA） use in the patients undergoing cervical spine surgery. Methods A total of 100 patients of both sexes, aged 55-75 yr, with body mass index of 19.0-25.0 kg/m2, of American Society of Anesthesiologists physical status I or II, undergoing elective cervical lamineetomy and instrumentation, were divided into TXA group and normal saline group （ group NS） using a random number table, with 50 patients in each group. TXA 15 mg/kg was intraw,nously injected at 30 rain betbre skin incision in group TXA, and the equal vol- ume of normal saline was given instead in group NS. Hemoglobin was measured before operation and on postoperative days 1, 3 and 5. The intraoperative, postoperative, total blood loss, hidden blood loss and requirement for blond （allugeneic and aulnlogous blood） transfusion were recorded. The development of complications such as epidural hematoma, deep vein thrombosis and pulmonary embolism was also recorded. Results Compared with group NS, the postoperative blood loss, Iotal blood loss and blood transfusion rate were significantly decreased, the posloperative hernoglnbin was increased （P〈0.05）, and no signifi- cant change was tound in the intraoperative blood loos or hidden blond loss in group TXA （P〉0.05）. No patients developed eonqlieations such as el）i（hJral hematnnm, deep vein thrombosis or pulmonary embolism in the two groups. Conclusion Prophylaetic TXA use produces blnod-saving effect to some extenl in the patients undergoing cervical spine surgery.