氨甲环酸减少单节段腰椎融合术后失血量的临床研究  

Clinical study of tranexamic acid in reducing blood loss after single segment lumbar fusion

作　　者：刘涛[1] 刘玉平[1] LIU Tao;LIU Yu-ping(Orthopedics Department of Tengzhou Central People ＇ s Hospital, Tengzhou , Shandong , 277500 Chin)

机构地区：[1]滕州市中心人民医院骨科,山东滕州277500

出　　处：《中国冶金工业医学杂志》2018年第3期260-262,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的探讨局部应用氨甲环酸对减少单节段腰椎融合术术后出血的影响。方法选取本科室2015年11月至2017年1月拟行单阶段腰椎融合术的患者78例,随机分为对照组和实验组,每组各39例。实验组在关闭切口前将1g氨甲环酸加入生理盐水配置成20ml混合液给予切口内及切口周围注射,对照组给予相同剂量生理盐水注射。比较两组患者术前、术后血红蛋白、红细胞压积、术中失血量和术后引流量、D-二聚体和活化的部分凝血活酶时间等凝血指标的变化以及两组输血患者的数量,同时观察患者是否出现下肢深静脉血栓症状。结果实验组患者术后血红蛋白、红细胞压积、术后引流量、输血例数均较对照组明显减少,差异有统计学意义(P<0.05)。两组患者术后均未发现下肢深静脉血栓形成。结论局部应用氨甲环酸能明显减少腰椎单节段融合术后的失血量及输血量,且不增加下肢静脉血栓形成的风险。Objective To investigate the effect of topical application of tranexamic acid on the reduction of bleeding after single stage lumbar fusion.Methods 78 undergoing single segment lumbar fusion in our department from November 2015 to January 2017 was selected,and randomly divided into control group and experimental group（n=39）.20 ml mixed solution configured with 1 g of tranexamic acid added to the physiological saline solution were injected into and around the incision before the closure of the wound in experimental group.The same dose of saline were injected in the control group.Hemoglobin,hematocrit,intraoperative blood loss,postoperative drainage,blood coagulation indexes such as D-dimer and activated partial thromboplastin time before and after operation were compared between the two groups.The number of blood transfusion,and observe the clinical symptoms of patients with lower extremity deep vein thrombosis.Results The postoperative hemoglobin,hematocrit,postoperative drainage and the number of blood transfusion in the experimental group were more significantly decreased than that in control group,the difference was statistically significant（P〈0.05）.No lower extremity deep vein thrombosis was found in both groups.Conclusion Topical application of tranexamic acid can obviously reduce blood loss and blood transfusion after lumbar single segment fusion without increasing the risk of venous thrombosis of lower extremity.

关 键 词：氨甲环酸 腰椎融合 出血 血栓 

分 类 号：R681.5[医药卫生—骨科学]