Krohn Claus Danckert, Sørensen Roger, Lange Johan Emil, Riise Rolf, Bjørnsen Stine, Brosstad Frank
Department of Anaesthesiology, Centre for Orthopaedics, Rikshospitalet, University of Oslo, Oslo, Norway.
Eur J Surg Suppl. 2003 Jul(588):57-61.
To evaluate the effect of locally applied tranexamic acid on postoperative blood loss and measures of fibrinolysis in drained blood.
Prospective study.
University hospital, Norway.
30 patients operated on for low back pain by screw fixation of the lumbar spine, 16 of who were randomised to be given topical tranexamic acid.
Postoperative blood loss after 18 hours. Concentrations of plasmin/alpha2-antiplasmin (PAP) and D-dimer in arterial and drained blood at the time of wound closure and in drained blood after 1 hour.
In the tranexamic group median (interquartile) blood loss was reduced by half from 525 (325-750) ml to 252 (127-465) ml, p = 0.02. In drained blood after one hour the increase in the concentration of PAP was 150 (109-170)% and D-dimer 150 (107-272)% in the tranexamic group compared with the control group where the increase in PAP was 320 (140-540)% and D-dimer 260 (161-670)%.
Tranexamic acid applied in the wound inhibits blood loss by up to a half in major orthopaedic surgery probably because it prevents excessive fibrinolysis.
评估局部应用氨甲环酸对术后失血量及引流血液中纤维蛋白溶解指标的影响。
前瞻性研究。
挪威大学医院。
30例因腰椎疼痛接受腰椎螺钉固定手术的患者，其中16例被随机分配接受局部氨甲环酸治疗。
术后18小时的失血量。伤口闭合时动脉血和引流血液中纤溶酶/α2-抗纤溶酶（PAP）和D-二聚体的浓度，以及术后1小时引流血液中的浓度。
氨甲环酸组的中位（四分位间距）失血量从525（325 - 750）ml减少了一半，降至252（127 - 465）ml，p = 0.02。与对照组相比，氨甲环酸组术后1小时引流血液中PAP浓度升高150（109 - 170）%，D-二聚体升高150（107 - 272）%，而对照组PAP浓度升高320（140 - 540）%，D-二聚体升高260（161 - 670）%。
伤口局部应用氨甲环酸可使大型骨科手术的失血量减少多达一半，可能是因为它可防止过度纤维蛋白溶解。
