天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
9期
1044-1046
,共3页
氨甲环酸%脊柱侧凸%脊柱融合术%失血,手术
氨甲環痠%脊柱側凸%脊柱融閤術%失血,手術
안갑배산%척주측철%척주융합술%실혈,수술
tranexamic acid%scoliosis%spinal fusion%blood loss,surgical
目的：评价氨甲环酸（TXA）在青少年脊柱侧凸后路融合固定手术中控制出血量的有效性及安全性。方法选取因青少年脊柱侧凸行后路融合固定术的患者93例，TXA组43例，术中使用TXA（先给予1 g负荷剂量，然后按100 mg/h维持剂量给药），对照组50例，术中未使用TXA或其他抗纤溶药。比较2组的术中及术后临床指标。结果 TXA组术中失血量低于对照组[（703±176）mL vs (1143±389)mL]，术后引流量低于对照组[(145±75)mL vs （278±95）mL]。TXA组患者术中自体血回收量低于对照组[(241.0±109.1) mL vs (372.7±123.0)mL]，回输量也少于对照组[（189.6±84.1）vs（302.1±96.0）]。未见明显并发症。TXA组无输异体血者，对照组1例输异体血400 mL。结论青少年特发性脊柱侧凸后路固定融合手术中静脉应用TXA可以有效减少术中失血和输血量，不增加术中及术后并发症。
目的：評價氨甲環痠（TXA）在青少年脊柱側凸後路融閤固定手術中控製齣血量的有效性及安全性。方法選取因青少年脊柱側凸行後路融閤固定術的患者93例，TXA組43例，術中使用TXA（先給予1 g負荷劑量，然後按100 mg/h維持劑量給藥），對照組50例，術中未使用TXA或其他抗纖溶藥。比較2組的術中及術後臨床指標。結果 TXA組術中失血量低于對照組[（703±176）mL vs (1143±389)mL]，術後引流量低于對照組[(145±75)mL vs （278±95）mL]。TXA組患者術中自體血迴收量低于對照組[(241.0±109.1) mL vs (372.7±123.0)mL]，迴輸量也少于對照組[（189.6±84.1）vs（302.1±96.0）]。未見明顯併髮癥。TXA組無輸異體血者，對照組1例輸異體血400 mL。結論青少年特髮性脊柱側凸後路固定融閤手術中靜脈應用TXA可以有效減少術中失血和輸血量，不增加術中及術後併髮癥。
목적：평개안갑배산（TXA）재청소년척주측철후로융합고정수술중공제출혈량적유효성급안전성。방법선취인청소년척주측철행후로융합고정술적환자93례，TXA조43례，술중사용TXA（선급여1 g부하제량，연후안100 mg/h유지제량급약），대조조50례，술중미사용TXA혹기타항섬용약。비교2조적술중급술후림상지표。결과 TXA조술중실혈량저우대조조[（703±176）mL vs (1143±389)mL]，술후인류량저우대조조[(145±75)mL vs （278±95）mL]。TXA조환자술중자체혈회수량저우대조조[(241.0±109.1) mL vs (372.7±123.0)mL]，회수량야소우대조조[（189.6±84.1）vs（302.1±96.0）]。미견명현병발증。TXA조무수이체혈자，대조조1례수이체혈400 mL。결론청소년특발성척주측철후로고정융합수술중정맥응용TXA가이유효감소술중실혈화수혈량，불증가술중급술후병발증。
Objective To assess the efficacy and safety of tranexamic acid (TXA) in decreasing operative blood loss and the need for transfusion during posterior spinal fusion for the treatment of idiopathic scoliosis in adolescents. Methods A retrospective comparative analysis of 93 consecutive adolescents undergoing posterior spinal fusion procedures was per?formed. Patients were divided into treatment group (TXA, n=43) and control group (n=50). Clinical indicators were compared in operation and after operation between two groups. Results There was significantly less operative blood loss (703±176) mL in TXA group than that of control group (1143±389) mL. And post operation flow was also lower in TXA group than that of control group [(145 ± 75)mL vs (278 ± 95) mL, P<0.001)]. Autologous blood recovery in patients was lower in TXA group than that of control group [(241.0±109.1) mL vs (372.7±123.0) mL, P<0.001). There were no major intraoperative complica?tions in two groups. There was no blood transfusion in TXA group, and there was 1 case with 400 mL blood transfusion in con?trol group. Conclusion TXA treatment can decrease blood loss and blood transfusion and not increase intraoperative and postoperative complications in surgery of posterior spinal fusion of adolescent idiopathic scoliosis.
