氨甲环酸减少脊柱矫形术围术期出血的临床观察  

Clinical study on tranexamic acid to reduce perioperative blood 1oss in spinal correction surgery

作　　者：曾凡杰[1] 陈芬兰[1] 潘志国[2] 袁芳芳[2] 马向阳[3] 

机构地区：[1]广州军区广州总医院急诊科,广东广州510010 [2]广州军区广州总医院ICU,广东广州510010 [3]广州军区广州总医院骨科医院脊柱科,广东广州510010

出　　处：《临床和实验医学杂志》2013年第13期1036-1037,1039,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察抗纤溶药物氨甲环酸在减少脊柱矫形术围术期出血的疗效与安全性。方法收集2008年1月至2011年10月接受脊柱矫形手术92例随机分成两组,治疗组41例手术开始前15 min给于氨甲环酸1 g负荷量缓慢静脉注射10 min,手术开始后持续给以10 mg/(kg.h)的氨甲环酸维持量TXA[10 mg/(kg.h)]至手术结束。对照组51例给予相应生理盐水;比较两组患者术中、术后24 h失血量、输血量并观察出凝血功能及药物副反应。结果①与照组相比,治疗组术中失血量、输血量、术后24 h引流量均显著减少;②两组凝血酶原时间(PT)、凝血活酶时间(APTT)、国际标准化比值(INR)、纤维蛋白原(FIB)差异无统计学意义(P>0.05)。术后无深静脉血栓、肾功能衰竭、心肌梗死、脑梗塞、伤口感染等并发症的发生。结论静脉应用氨甲环酸抗纤溶治疗对脊柱矫形术围术期止血安全有效。Objective To study the efficacy and safety of tranexamic acid in antifibrinolytic treatment to reduce perioperative bleeding loss in spinal correction surgery.Methods A series of 92 patients with spinal surgery were randomly assigned to receive tranexamic acid at 1g before incision then infusion of 10 mg/kg/h up to end of surgery or matching placebo.The Placebo group received the same amount of saline.Two groups were compared in intraoperative bleeding,postoperative bleeding,transfusion,blood clotting and side effects.Results ①There was significantly different in intraoperative bleeding,postoperative bleeding,transfusion compared with placebo group.②.There was insignificantly different in PT,APTT,INR,FIB compared with placebo group.③The coagulation system had no significant change,and no major adverse effects occurred in both groups before and post operation.Conclusion Tranexamic acid in spinal correction surgery can significantly reduce blood loss and transfusion.Tranexamic acid is safe and effective in spinal correction surgery.

关 键 词：脊柱矫形 出血 氨甲环酸 

分 类 号：R687.3[医药卫生—骨科学]