氨甲环酸对癫痫手术患儿术中失血量及输血量的影响

Retrospective analysis on the influence of tranexamic acid on intraoperative blood loss and blood transfusion volume of children patients during epilepsy surgery

目的回顾性分析术中给予氨甲环酸（tranexamic acid, TXA）对癫痫手术患儿术中出血量及输血量的影响。方法择期行癫痫病灶切除术的患儿45例，根据患儿年龄和是否使用TXA注射液分为4组：3岁及以下未用TXA组（N1组，9例）、3岁及以下使用TXA组（TXA1组，11例）、3岁以上未用TXA组（N2组，9例）和3岁以上使用TXA组（TXA2组，16例）。比较4组患儿术前和术后RBC、Hct、Hb、血小板的变化，以及术中失血量、尿量、输血量、输液量、公斤失血量、失血量占估计血容量百分比的差异。结果N1组与TXA1组比较，N2组与TXA2组比较，患儿身高、体重、手术时间、估计血容量差异无统计学意义（P〉0.05）。TXA1组患儿失血量、输血量、公斤失血量、失血量占估计血容量百分比均小于N1组（P〈0.05），TXA2组患儿失血量、输血量小于N2组（P〈0.05），其余指标差异无统计学意义（P〉0.05）。TXA1组、N2组和TXA2组术后RBC、Hct、Hb、血小板均低于术前（P〈0.05）。与N1组比较，TXA1组术后RBC、Hct、Hb均降低（P〈0.05）；与N2组比较，TXA2组各项指标差异无统计学意义（P〉0.05）。结论TXA可有效降低癫痫病灶切除术患儿术中失血量及输血量。

Objective A retrospective analysis was made on the influence of tranexamic acid（TXA） on intraoperative blood loss and blood transfusion volume of children patients during epilepsy surgery.Methods Children patients that received epileptic foci resection from January to December 2017 were included in the study and they were divided into group N1（aged 3 and below）, group N2（more than 3 years old）, group TXA1（aged 3 and below） and group TXA2（more than 3 years old） according to the using condition of TXA. The erythrocyte, hematocrit, hemoglobin, hematoblastic changes of children from all groups before and after surgery were compared. The difference in intraoperative blood loss, urine volume, blood transfusion volume, liquid transfusion volume, blood loss per kilograms and the proportion of blood loss in estimated blood volume were compared.Results The difference in height, weight, length of surgery, estimated blood volume, urine volume, transfusion volume between four groups had no statistical significance. The intraoperative blood loss, transfusion volume, blood loss volume per kilogram and the proportion of blood loss volume in estimated blood volume of group TXA1 were all lower than that of group N1（P〈0.05）. The intraoperative blood loss and transfusion volume of group TXA2 were lower than volumes of group N2（P〈0.05）. The postoperative erythrocyte, hematocrit, hemoglobin, blood platelet of patients from group TXA1, group N2 and group TXA2 were lower than values before surgery（P〈0.05）, the postoperative erythrocyte, hematocrit, hemoglobin of patients from group TXA1 were lower than the values of patients from group N1（P〈0.05）.Conclusions TXA can effectively reduce intraoperative blood loss and blood transfusion volume of child patient during epilepsy surgery.