止血纱联合氨甲环酸使用减少脑出血术后再发出血的风险

Application of Hemostatic Gauze Combined with Tranexamic Acid on Reducing the Risk of Bleeding after Cerebral Hemorrhage

目的探讨止血纱联合氨甲环酸使用减少脑出血术后再发出血的原因。方法回顾性分析2005年1月—2016年12月期间德宏州人民医院神经外科手术治疗脑出血617例,所有患者术前、术后都使用氨甲环酸治疗,实验组315例患者术中使用止血纱辅助止血,对照组302例患者术中仅使用明胶海绵辅助止血。观察对比两组患者术后1、3、7 d再发出血的比例。结果实验组术后1、3、7 d再发出血的发生率分别是4.13%(13/315)、2.22%(7/315)、0.63%(2/315),明显低于对照组9.27%(28/302)、6.62%(20/302)、4.97%(15/302)。结论止血纱在脑出血术中的合理使用能有效减少术后再发出血的风险,明显降低非计划二次手术的发生率。

Objective This paper tries to explore the reason why hemostatic gauze combined with tranexamic acid can be used to reduce the bleeding after cerebral hemorrhage. Methods 617 cases of cerebral hemorrhage from January 2005 to December 2016 in the Dehong People's Hospital of neurosurgery treatment were selected and retrospectively analyzed, all patients underwent preoperative and postoperative tranexamic acid for treatment. In the experimental group, 315 patients were treated with hemostatic gauze to stop bleeding. In the control group, 302 patients were treated with gelatin sponge alone, and then the proportion of bleeding after 1 day, 3 days, 7 days after surgery of the two groups were observed. Results The incidence of rebleeding in the experimental group was 4.13%(13/315), 2.22%(7/315) and 0.63%(2/315) respectively after 1 day, 3 days and 7 days respectively, significantly lower than that of the control group of 9.27%(28/302), 6.62%(20/302), 4.97%(15/302). Conclusion The rational use of hemostatic gauze in cerebral hemorrhage can effectively reduce the risk of postoperative rebleeding, significantly reduce the incidence of unplanned secondary surgery.