Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
Orthopaedic Research Centre, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Int J Environ Res Public Health. 2021 Sep 22;18(19):9959. doi: 10.3390/ijerph18199959.
Intravenous tranexamic acid (TXA) has been administered to reduce intraoperative blood loss in scoliosis surgery. However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group ( = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion ( < 0.001), crystalloid volume ( = 0.041), and total transfusion volume ( = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume ( = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications.
静脉注射氨甲环酸（TXA）已被用于减少脊柱侧凸手术中的术中失血。然而，TXA 治疗脊髓性肌萎缩症（SMA）脊柱侧凸手术的疗效尚未得到充分证实。因此，本研究旨在评估静脉注射 TXA 在 SMA 脊柱侧凸手术中的疗效。从 1993 年 12 月至 2020 年 8 月，回顾性纳入了 30 例接受脊柱侧凸手术（后路融合，融合部位为胸 2 或 3 至骨盆）的 SMA 患者，并将其分为 TXA 组和非-TXA（对照组），每组 15 例。调查参数包括出血量、输血量、晶体液输注量、插管时间和相关肺部并发症（包括肺炎、肺水肿和肺不张）。TXA 组的出血量明显少于对照组（ = 0.011）。与对照组相比，TXA 组的输血（ < 0.001）、晶体液量（ = 0.041）和总输血量（ = 0.005）均明显减少。此外，TXA 组术后肺部并发症较少，发生肺部并发症的患者相对晶体液量和相对总输血量较高（分别为 = 0.003 和 0.022）。总之，TXA 可有效减少 SMA 患者脊柱侧凸手术中的术中失血和晶体液输注，可能有助于减少术后肺部并发症。
