Department of Orthopaedic Surgery, Mount Sinai Hospital, Icahn School of Medicine, 5 E 98th St., 4th Floor, New York, NY, 10029, USA.
Department of Pediatrics, Mount Sinai Kravis Children's Hospital, New York, NY, USA.
Spine Deform. 2022 Jul;10(4):811-816. doi: 10.1007/s43390-022-00492-x. Epub 2022 Mar 9.
Anterior vertebral body tethering (VBT) is a non-fusion surgical treatment for Adolescent Idiopathic Scoliosis requiring chest tube(s) (CT). We sought to assess the efficacy of post-op intravenous tranexamic acid (IV TXA) in reducing CT drainage and retention.
35 VBT patients received 24 h of post-op IV TXA (2 mg/kg/h) were compared to 49 who did not. Group comparisons were performed using Wilcoxon rank-sum and chi-squared tests. Multivariate linear regression analysis was used to assess the relationships between TXA and both CT drainage and retention time.
There were no group differences at baseline (Table). CTs placed for thoracic (T) and thoracolumbar (TL) curves were assessed separately. For TH CT, there was less total CT drainage in the TXA group (TXA 569.4 ± 337.4 mL vs. Non-TXA 782.5 ± 338.9 mL; p = 0.003) and shorter CT retention time (TXA 3.0 ± 1.3 vs. Non-TXA 3.9 ± 1.4 days; p = 0.003). For TL CT, there was less total CT drainage in the TXA group (TXA 206.8 ± 152.2 mL vs. Non-TXA 395.7 ± 196.1 mL; p = 0.003) and shorter CT retention time (TXA 1.7 ± 1.3 vs. Non-TXA 2.7 ± 1.0 days; p = 0.001). Following multivariate analysis, use of TXA was the only significant predictor of both drainage in T and TL CTs (p = 0.012 and p = 0.002, respectively) as well as T and TL CT retention time (p = 0.008 and p = 0.009, respectively). There were no differences in LOS (p = 0.863) or ICU stay (p = 0.290).
IV TXA results in a significant decrease in CT drainage and retention time. CT retention is decreased by 1 day for those that receive TXA.
III.
椎体前方拴系术（VBT）是一种非融合手术治疗青少年特发性脊柱侧凸，需要放置胸腔引流管（CT）。我们旨在评估术后静脉注射氨甲环酸（IV TXA）减少 CT 引流和滞留的效果。
35 例 VBT 患者接受 24 小时术后 IV TXA（2mg/kg/h）治疗，并与 49 例未接受治疗的患者进行比较。使用 Wilcoxon 秩和检验和卡方检验进行组间比较。采用多元线性回归分析评估 TXA 与 CT 引流和留置时间之间的关系。
两组患者在基线时无差异（表）。分别评估 T 型和胸腰椎（TL）曲线 CT 的置管情况。对于 TH CT，TXA 组的总 CT 引流量更少（TXA 569.4±337.4mL 比非-TXA 782.5±338.9mL；p=0.003），CT 留置时间更短（TXA 3.0±1.3 比非-TXA 3.9±1.4 天；p=0.003）。对于 TL CT，TXA 组的总 CT 引流量更少（TXA 206.8±152.2mL 比非-TXA 395.7±196.1mL；p=0.003），CT 留置时间更短（TXA 1.7±1.3 比非-TXA 2.7±1.0 天；p=0.001）。多元分析后，TXA 的使用是 T 和 TL CT 引流和留置时间的唯一显著预测因素（p=0.012 和 p=0.002），以及 T 和 TL CT 留置时间（p=0.008 和 p=0.009）。两组住院时间（p=0.863）和 ICU 住院时间（p=0.290）均无差异。
IV TXA 可显著减少 CT 引流和留置时间。接受 TXA 治疗的患者 CT 留置时间减少 1 天。
III 级。
