Kargar-Soleimanabad Saeed, Khormali Aynoor, Godazandeh Farnaz, Najafi Sajjad
Student Research Committee, Faculty of Medicine.
Department of Radiology and Nuclear Medicine, School of Medicine, Sari Imam Khomeini Hospital.
Ann Med Surg (Lond). 2024 Jun 10;86(8):4483-4487. doi: 10.1097/MS9.0000000000001820. eCollection 2024 Aug.
This study aimed to investigate the effect of oral administration of tranexamic acid (TXA) on reducing intraoperative bleeding during spinal surgeries.
The study was a single-center, double-blind, randomized, placebo-controlled clinical trial. Participants were individuals over 20 years old who underwent spinal surgery. Patients received 1.5 g of TXA orally, 2 h before surgery. Intraoperative bleeding volume, blood volume in the drain after surgery, length of hospital stays after surgery, incidence of nausea or vomiting, decrease in hemoglobin (Hb) level, and postoperative coagulation test results were evaluated in each group.
In this study, patients were assigned to each study group based on inclusion and exclusion criteria. The mean age of patients was 69.6±6.47 years, and 65% were male. There was no significant difference in age, sex, pre and postoperative Hb levels, prothrombin time (PT), or international normalized ratio (INR) between the study groups. Intraoperative bleeding volume and blood volume in the drain after surgery were significantly lower in the TXA group. Additionally, the length of hospital stay after surgery was significantly shorter in the TXA group. The incidence of nausea or vomiting was significantly higher in the TXA group. Furthermore, postoperative partial thromboplastin time (PTT) was significantly higher in the TXA group compared to the placebo group.
Oral administration of TXA before spinal surgery leads to a significant reduction in intraoperative and postoperative bleeding without significant adverse effects and also reduces the length of hospital stay.
本研究旨在探讨口服氨甲环酸（TXA）对减少脊柱手术术中出血的效果。
本研究为单中心、双盲、随机、安慰剂对照临床试验。参与者为20岁以上接受脊柱手术的个体。患者在手术前2小时口服1.5克TXA。评估每组的术中出血量、术后引流管中的出血量、术后住院时间、恶心或呕吐的发生率、血红蛋白（Hb）水平的下降以及术后凝血试验结果。
在本研究中，根据纳入和排除标准将患者分配到每个研究组。患者的平均年龄为69.6±6.47岁，65%为男性。研究组之间在年龄、性别、术前和术后Hb水平、凝血酶原时间（PT）或国际标准化比值（INR）方面无显著差异。TXA组的术中出血量和术后引流管中的出血量显著较低。此外，TXA组的术后住院时间显著较短。TXA组恶心或呕吐的发生率显著较高。此外，与安慰剂组相比，TXA组术后部分凝血活酶时间（PTT）显著较高。
脊柱手术前口服TXA可显著减少术中及术后出血，且无明显不良反应，还可缩短住院时间。
