Chen Qian, Zhou Qingsong, Feng Junfei, Zhang Qingyan, Li Yuling, Zhang Jianguang, Ren Yuqing, Chen Lu, Wei Peng
Department of Orthopedics, Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan, 637000, P.R.China.
Department of Lower Limbs, Sichuan Provincial Orthopedic Hospital, Chengdu Sichuan, 610041, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Jul 15;35(7):873-877. doi: 10.7507/1002-1892.202101084.
To investigate the safety and effectiveness of low-dose tranexamic acid (TXA) in operation of multi-level continuous thoracic ossification of ligament flavum (TOLF).
A clinical data of 26 patients who underwent operation for multi-level continuous TOLF and met the selection criteria between July 2015 and January 2019 was retrospectively analyzed. Among them, 13 cases (group A) were received intravenous infusion of TXA (10 mg/kg) at 15 minutes before operation, and maintained the infusion at 1 mg/(kg·h) until the end of the operation; 13 cases (group B) were received the same dose of normal saline before and during operation. There was no significant difference in gender, age, body mass index, diseased segment, and preoperative hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, international normalized ratio (INR) between the two groups ( >0.05). The hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, INR, the number of deep vein thrombosis of the lower extremities, operation time, intraoperative blood loss, postoperative drainage volume, total blood loss, and the time of drainage tube extubation in the two groups were recorded and compared.
All operations in the two groups were successfully completed. Compared with group B, the operation time and time of drainage tube extubation in group A were shortened, and the intraoperative blood loss, postoperative drainage volume, and total blood loss were reduced. The differences between the two groups were significant ( <0.05). None of the two groups received blood transfusion, and the hemoglobin level of group A at 24 hours after operation was significantly higher than that of group B ( =5.062, =0.000). The incisions in both groups healed and sutures were removed within 2 weeks after operation, and no complications occurred. There was no significant difference between the two groups in activated partial thromboplastin time, prothrombin time, INR, and platelet count at 24 hours after operation ( >0.05).
In multi-level continuous TOLF operation, intravenous administration of low-dose TXA can effectively reduce blood loss, shorten postoperative drainage time, and does not increase the risk of complications.
探讨低剂量氨甲环酸（TXA）在多节段连续型胸椎黄韧带骨化症（TOLF）手术中的安全性和有效性。
回顾性分析2015年7月至2019年1月期间26例行多节段连续型TOLF手术且符合入选标准的患者的临床资料。其中，13例（A组）于手术前15分钟静脉输注TXA（10 mg/kg），并以1 mg/（kg·h）维持输注直至手术结束；13例（B组）在手术前及手术期间输注相同剂量的生理盐水。两组患者在性别、年龄、体重指数、病变节段以及术前血红蛋白、血小板计数、活化部分凝血活酶时间、凝血酶原时间、国际标准化比值（INR）方面差异均无统计学意义（>0.05）。记录并比较两组患者的血红蛋白、血小板计数、活化部分凝血活酶时间、凝血酶原时间、INR、下肢深静脉血栓形成数量、手术时间、术中出血量、术后引流量、总失血量以及引流管拔除时间。
两组手术均顺利完成。与B组相比，A组手术时间及引流管拔除时间缩短，术中出血量、术后引流量及总失血量减少。两组差异有统计学意义（<0.05）。两组均未输血，且A组术后24小时血红蛋白水平显著高于B组（=5.062，=0.000）。两组切口均愈合，术后2周内拆线，未发生并发症。两组术后24小时活化部分凝血活酶时间、凝血酶原时间、INR及血小板计数差异无统计学意义（>0.05）。
在多节段连续型TOLF手术中，静脉给予低剂量TXA可有效减少出血量，缩短术后引流时间，且不增加并发症风险。
