氨甲环酸减少颈椎后路单开门椎管成形术围手术期失血的有效性及安全性研究

Study on the Effects and Safety of Tranexamic Acid in Reducing Blood Loss during the Perioperative Period of Posterior Open-door Laminoplasty

目的:探讨氨甲环酸(TXA)在减少颈椎后路单开门椎管成形术围手术期失血量的有效性及安全性。方法:将50例颈椎后路单开门椎管成形术的患者随机分为TXA组与对照组,每组25例。TXA组患者于麻醉生效后、切皮前10 min静脉输注氨甲环酸氯化钠注射液,10 mg/kg;对照组输注0.9%氯化钠注射液,10 mg/kg。对比术中出血量及术后24 h引流量,比较两组患者深静脉血栓的发生率。结果:两组患者术中失血量比较,差异无统计学意义(P>0.05)。TXA组术后引流量及血红蛋白量明显优于对照组,差异有统计学意义(P<0.05),两组术后均无深静脉血栓发生。结论:TXA可减少后入路颈椎单开门成形术围手术期出血量,且不增加血栓事件,使用安全、有效。

Objective： To investigate the effects and safety of Tranexamic Acid（TXA） in reducing blood loss during the perioperative period of posterior open-door laminoplasty.Method： 50 patients undergoing posterior open-door laminoplasty were randomly divided into TXA group and control group, 25 cases in each group.After the anesthesia, the patients in TXA group were injected intravenous 10 mg/kg infusion of Tranexamic Acid sodium chloride injection 10 min before skin inclsion.The control group was injected 0.9% sodium chloride injection with equivalent dose of the TXA group.The intraoperative blood loss, the postoperative 24 h volume of drainage and the incidence of deep venous thrombosis in the two groups were compared.Result： There was no significant difference of the blood loss between the two groups（P〉0.05）.Postoperative drainage volume and hemoglobin content of the TXA group were significantly better than those of the control group, the differences were statistically significant（P〈0.05）.There was no deep venous thrombosis occurred after operation in both groups.Conclusion： TXA can reduce the amount of bleeding during the perioperative period of cervical single open surgery, and not increase complications.