氨甲环酸对胸腰椎骨折脱位围手术期失血的影响  

Effect of tranexamic acid on perioperative blood loss of thoracolumbar fracture and dislocation

作　　者：刘筱 徐志愿 崔建 张寰 龙浩 姚爱明 燕宪亮 朱锋辉 LIU Xiao;XU Zhi-yuan;CUI Jian;ZHANG Huan;LONG Hao;YAO Ai-ming;YAN Xian-liang;ZHU Feng-hui(Emergency Trauma Center,Afiliated Hospi-tal,Xuzhou Medical University,Xuzhou 221002,China;Postgraduate School,Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院急诊创伤中心,江苏徐州221002 [2]徐州医科大学研究生院,江苏徐州221000

出　　处：《中国矫形外科杂志》2023年第6期551-554,共4页Orthopedic Journal of China

基　　金：中国博士后科学基金资助项目(编号:2019M651966);徐州市推动科技创新专项社会发展重点研发项目(编号:KC19175);江苏省医院管理创新研究课题项目(编号:JSYGY-3-2020-30)。

摘　　要：[目的]探讨氨甲环酸(tranexamicacid, TXA)减少胸腰椎骨折脱位围术期失血中的作用。[方法]回顾性分析2013年1月—2021年6月本院手术治疗胸腰椎骨折脱位63例患者的临床资料,其中TXA组33例,非TXA组30例。比较两组患者围术期和血液学检验资料。[结果] TXA组手术时间、术中出血量、术后24 h引流量显著优于非TXA组(P<0.05)。术后第3 d常规行双侧下肢血管超声检查,均未见深静脉血栓形成。与术前相比,两组患者术后第1 d Hb、Hct、PLT均显著减少(P<0.05),PT显著增加(P<0.05),而APTT的差异无统计学意义(P>0.05)。术前两组上述检验指标的差异均无统计学意义(P>0.05);术后第1 d,TXT组Hb、Hct、PLT水平均显著高于非TXA组(P<0.05),但两组PT和APTT差异无统计学意义(P>0.05)。[结论]术前静脉应用氨甲环酸可以有效减少胸腰椎骨折脱位围术期出血量,疗效安全可靠。[Objective] To investigate the effect of tranexamic acid(TXA) on perioperative blood loss of thoracolumbar fracture and dislocation. [Methods] A retrospective study was performed on 63 patients who underwent surgical treatment for thoracolumbar fracture and dislocation in our hospital from January 2013 to June 2021, including 33 patients in the TXA group and 30 patients in the non-TXA group.The perioperative and blood test data of the two groups were compared. [Results] The TXA group proved significantly superior to the nonTXA group in terms of operation time, intraoperative blood loss and drainage 24 hours after operation(P<0.05). On the third day after operation, no deep vein thrombosis was found by ultrasound in anyone of both groups. Compared with those preoperatively, the Hb, Hct and PLT significantly decreased(P<0.05), while the PT significantly increased(P<0.05), and APTT remained unchanged significantly 1 day postoperatively in both groups(P>0.05). Although there was no significant difference in the above blood test parameters between the two groups before operation(P>0.05), the TXA group had significantly higher Hb, Hct and PLT than the non-TXA group 1 day postoperatively(P<0.05), whereas there was no significant difference in PT and APTT between the two groups(P>0.05). [Conclusion] Preoperative intravenous tranexamic acid does effectively reduce perioperative blood loss of thoracolumbar fracture and dislocation, which is safe and reliable.

关 键 词：胸腰椎骨折脱位 氨甲环酸 出血 血栓 并发症 

分 类 号：R683.2[医药卫生—骨科学]