Department of Orthopaedic Surgery, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
Department of Anaesthesiology, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
J Int Med Res. 2024 Sep;52(9):3000605241285661. doi: 10.1177/03000605241285661.
To evaluate the safety and efficacy of intravenous tranexamic acid (TXA) administration in anterior cervical discectomy fusion (ACDF) for the treatment of cervical spondylosis in the elderly.
Data from elderly patients who underwent ACDF between January 2020 and January 2023 were retrospectively reviewed. Patients who received 1 g intravenous TXA administration before skin incision (TXA group) were compared with patients who did not receive TXA (controls). Total and hidden blood loss were calculated, and the following outcomes were recorded: haemoglobin and haematocrit drop, operation time, drainage duration, drain volume, length of hospitalization, coagulation changes, and incidence of complications.
A total of 114 patients were included (TXA group, = 53 and controls, = 61). Total blood loss, hidden blood loss, and postoperative drainage volume, haemoglobin and haematocrit drop were significantly lower in the TXA group than the control group. There were no significant differences in operation time, intraoperative blood loss, drainage duration, length of hospitalization, or coagulation function between the two groups. The incidence of complications did not differ significantly between the two groups during 3 months of follow-up.
Intravenous TXA is effective in reducing perioperative blood loss in elderly patients undergoing ACDF without changing the coagulation function or increasing the risk of complications.
评估静脉注射氨甲环酸（TXA）在老年颈椎病前路颈椎间盘切除融合术（ACDF）中的安全性和疗效。
回顾性分析 2020 年 1 月至 2023 年 1 月期间接受 ACDF 的老年患者的数据。比较接受切口前 1g 静脉注射 TXA（TXA 组）和未接受 TXA 的患者（对照组）。计算总失血量和隐匿性失血量，并记录以下结果：血红蛋白和血细胞比容下降、手术时间、引流时间、引流量、住院时间、凝血变化和并发症发生率。
共纳入 114 例患者（TXA 组 53 例，对照组 61 例）。TXA 组总失血量、隐匿性失血量以及术后引流量、血红蛋白和血细胞比容下降均明显低于对照组。两组手术时间、术中失血量、引流时间、住院时间和凝血功能无显著差异。两组在 3 个月随访期间并发症发生率无显著差异。
静脉注射 TXA 可有效减少老年 ACDF 患者围手术期的失血，而不改变凝血功能或增加并发症风险。
