局部使用氨甲环酸减少腮腺肿瘤手术失血效果的临床分析  

Clinical analysis of the effect of topical application of tranexamic acid on reducing blood loss in parotid gland tumor surgery

作　　者：秦兆华 郭正峰 韩新生 QIN Zhaohua;GUO Zhengfeng;HAN Xinsheng(Department of Stomatology of Yellow River Central Hospital of Yellow River Water Conservancy Commission,Zhengzhou 450003,Henan Province,China;Department of Oral and Maxillofacial Surgery,Nanchong Central Hospital,the Second Clinical Medical College Of North Sichuan Medical College)

机构地区：[1]黄河水利委员会黄河中心医院口腔科,河南郑州450003 [2]南充市中心医院口腔颌面外科·川北医学院第二临床医学院

出　　处：《西南医科大学学报》2020年第4期374-377,共4页Journal of Southwest Medical University

摘　　要：目的:分析局部应用氨甲环酸对腮腺肿瘤切除术术中术后失血效果的影响。方法:2016年1月至2018年1月符合纳入标准的160例行单侧腮腺肿瘤及腺体全叶切除的患者随机分为对照组和观察组,两组各80例患者,其中观察组患者切口处局部注射用100 mL生理盐水+2 g氨甲环酸配制好的溶液,术中使用该溶液浸湿的纱布止血,对照组患者坏死处使用生理盐水注射并且术中使用生理盐水浸湿的纱布止血,记录术中失血量、术后引流量和输血量。术后2 h复查PT、APPT、FIB指标,24 h复查血常规。术前和术后24 h复查血常规。结果:观察组和对照组术中出血量比较差异有统计学意义(P <0.05),术后总失血量比较两组差异有统计学意义(P <0.05)。两组患者术后均未进行输血,术后血红蛋白浓度和红细胞压积对照组明显低于观察组,组间比较差异有统计学意义(P <0.05)。两组间术后凝血指标,输血率的比较差异无统计学意义(P> 0.05)。结论:腮腺肿瘤切除术中局部应用氨甲环酸是有效安全的,能明显减少术中及术后出血量,能降低患者围手术期因失血造成贫血相关并发症的风险,值得在临床推广应用。Objective: To analyze the effect of topical application of tranexamic acid on reducing blood loss during and after parotid gland tumor surgery. Methods: A total of 160 patients who had undergone unilateral parotid gland tumor surgery or total parotidectomy from January 2016 to January 2018 and met the inclusion criteria were randomly divided into control group and observation group, with 80 patients in each group. Patients in the observation group were topically injected(at the incision) with a solution of 2 g tranexamic acid in 100 mL physiological saline and underwent hemostasis with gauze soaked in the above solution;patients in the control group underwent hemostasis with gauze soaked in physiological saline. The intraoperative blood loss, postoperative drainage and blood transfusion were recorded. PT, APPT and FIB were checked 2 hours after operation, and blood routine was checked24 hours after operation. Results: There were significant differences between the observation group and the control group in intraoperative blood loss and total postoperative blood loss(P < 0.05). No postoperative blood transfusion occurred in either group, and the postoperative hemoglobin concentration and hematocrit were significantly lower in the control group than in the observation group(P < 0.05). There were no significant differences between the two groups in postoperative coagulation markers and blood transfusion rate(P > 0.05). Conclusion: The topical application of tranexamic acid in parotid gland tumor surgery is effective and safe. It can significantly reduce intraoperative and postoperative blood loss and lower the risk of anemia-related complications caused by perioperative blood loss.Therefore, it holds promise for clinical application.

关 键 词：失血 氨甲环酸 腮腺 肿瘤 手术 

分 类 号：R78[医药卫生—口腔医学]