氨甲环酸在腹腔镜胆囊切除术中对失血的作用

Role of Tranexamic Acid on Blood Loss in Laparoscopic Cholecystectomy.

作者信息

Pandove Paras Kumar, Singla Rachan Lal, Mittal Pallavi, Mahajan Nikhil, Kumar Ashwani

机构信息

Department of Surgery, Government Medical College and Rajindra Hospital, Patiala, Punjab, India.

出版信息

Niger J Surg. 2017 Jul-Dec;23(2):111-114. doi: 10.4103/njs.NJS_53_16.

DOI:10.4103/njs.NJS_53_16

PMID:29089735

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5649425/

Abstract

CONTEXT

Nonsurgical uses of tranexamic acid include the management of bleeding associated with leukemia, ocular bleeding, recurrent hemoptysis, menorrhagia, hereditary angioneurotic edema, and numerous other medical problems. However, there is hardly any documentation of the use of tranexamic acid in laparoscopic cholecystectomy.

AIMS

This study was conducted to evaluate the role of tranexamic acid in limiting blood loss in laparoscopic cholecystectomy and to evaluate the effect of blood loss on morbidity in terms of hospital stay and mortality of the patient.

SUBJECTS AND METHODS

The study was conducted on sixty patients admitted with gallstones, candidates for laparoscopic cholecystectomy. Thirty patients received an intravenous 20 mg/kg bolus dose of tranexamic acid at induction of anesthesia (Group A), and another thirty did not receive the aforementioned drug at induction (Group B).

STATISTICAL ANALYSIS

The two groups were compared, and the data collected were entered and tabulated using Microsoft Office Excel and analyzed using appropriate statistical tests.

RESULTS

The mean postoperative hospital stay (2.4 vs. 2.63, = 0.4147), drain fluid hemoglobin (Hb) (0.83 vs. 0.90, = 0.2087), drain fluid hematocrit (0.2434 vs. 0.2627, = 0.3787), mean drain output (85 vs. 87.23, = 0.9271), mean pulse rate at the start of surgery (74.2 vs. 75, > 0.999), mean pulse rate 24 h after surgery (75.9 vs. 76.4, = 0.5775), and mean change in Hb (0.240 vs. 0.266, = 0.2502) in both the groups were not significant.

CONCLUSIONS

There is no active role of tranexamic acid in elective laparoscopic cholecystectomy.

摘要

背景

氨甲环酸的非手术用途包括治疗与白血病相关的出血、眼部出血、反复咯血、月经过多、遗传性血管性水肿以及许多其他医学问题。然而，几乎没有关于氨甲环酸在腹腔镜胆囊切除术中应用的文献记载。

目的

本研究旨在评估氨甲环酸在限制腹腔镜胆囊切除术出血量方面的作用，并评估出血量对患者住院时间和死亡率等发病率的影响。

研究对象与方法

本研究针对60例因胆结石入院且适合进行腹腔镜胆囊切除术的患者。30例患者在麻醉诱导时静脉注射20mg/kg氨甲环酸推注剂量（A组），另外30例在诱导时未接受上述药物（B组）。

统计分析

对两组进行比较，收集的数据使用Microsoft Office Excel录入并制表，然后使用适当的统计检验进行分析。

结果

两组患者术后平均住院时间（2.4天对2.63天，P = 0.4147）、引流液血红蛋白（Hb）（0.83对0.90，P = 0.2087）、引流液血细胞比容（0.2434对0.2627，P = 0.3787）、平均引流量（85对87.23，P = 0.9271）、手术开始时平均脉搏率（74.2对75，P＞0.999）、术后24小时平均脉搏率（75.9对76.4，P = 0.5775）以及Hb平均变化量（0.240对0.266，P = 0.2502）均无显著差异。