氨甲环酸注射液联合吸收性明胶海绵局部用于腰椎手术中的临床研究  

Clinical application of tranexamic acid injection combined with absorbable gelatin sponge in lumbar spine surgery

作　　者：季旭彪 蒋小军[1] 恽诚明 厉晓龙[1] JI Xubiao;JIANG Xiaojun;YUN Chengming;LI Xiaolong(Department of Orthopedics,Wujin Hospital Affiliated to Jiangsu University,Changzhou 213017,Jiangsu,China)

机构地区：[1]江苏大学附属武进医院骨科,江苏常州213017

出　　处：《外科研究与新技术》2021年第1期22-26,共5页Surgical Research and New Technique

基　　金：常州市武进区科技支撑计划(社会发展)(WS201807)。

摘　　要：目的探究氨甲环酸注射液联合吸收性明胶海绵局部用于腰椎手术中对患者术后出血、手术结局及术后炎性因子表达的影响。方法随机选取2016年7月—2020年7月行腰椎手术患者60例,对照组仅采用吸收性明胶海绵,观察组在对照组基础上联合氨甲环酸注射液,比较两组患者前3个8 h引流量、总引流量、拔管时间、术后第1、3、7天红细胞比容(HCT)及血红蛋白(Hb)值及术后炎性因子表达等指标。结果观察组在第1个8 h引流量及总引流量显著少于对照组,且两组第1个8 h引流量与第2、3个8 h的引流量差异显著,第2、3个8 h引流量差异不显著。观察组术后第1天Hb及HCT要显著高于对照组,差异具有统计学意义(P<0.05),两组患者术前及术后3、7 d的Hb及HCT差异不显著(P>0.05)。治疗前,两组患者的血清炎性因子IL-6、IL-8、CRP及TNF-α水平对比,无明显差异(P>0.05)。治疗3 d后,两组患者的血清炎性因子水平均高于治疗前的血清炎性因子水平,且观察组患者的血清炎性因子水平显著高于对照组(P<0.05)。结论患者经氨甲环酸注射液联合吸收性明胶海绵治疗后,引流量大大减少,患者出血量得到有效控制,同时可有效控制患者炎性反应,值得临床推广。Objective To explore the effects of local application of tranexamic acid injection combined with absorbable gelatin sponge during lumbar spine surgery on patient’s postopereative hemorrhage,surgical outcome,and postoperative inflammation indicators.Methods Sixty patients undergoing lumbar spine surgery from July 2016 to July 2020 were randomly selected.The control group only used absorbable gelatin sponge,and the observation group additionally used tranexamic acid injection.The two groups were compared in first three 8 h drainage volumes,total drainage volume,extubation time,red blood cell volumes and Hb values at postoperative 1,3,and 7 days,and postoperative inflammation indicators.Results The observation group showed significantly reduced first 8 h and total drainage volumes than the control group;there were significant differences between the first 8 h volume and the second or third 8 h volume in both groups;no difference was observed between the second and the third 8 h volume.The Hb and HCT at postoperative 1 d in the observation group were significantly higher than those in the control group(P<0.05),and there were no significant differences before,3 d after,and 7 d after operation(P>0.05).Before treatment,there were no significant differences in serum inflammatory factors IL-6,IL-8,CRP,and TNF-αlevels between the two groups,and were higher in the observation group than in the control group(P<0.05);after 3 d of treatment,the serum inflammatory factor levels were higher than before(P<0.05).Conclusion After combined treatment using tranexamic acid injection and absorbable gelatin sponge,the drainage volume is greatly reduced in the patients,showing a good hemostasis effect,and the inflammatory reactions are well controlled as well;therefore,the combination is worthy of clinical promotion.

关 键 词：氨甲环酸注射液 吸收性明胶海绵 腰椎手术 手术结局 

分 类 号：R459.9[医药卫生—治疗学]