PDF(Pubmed)
Abstract：
Intravenous application of tranexamic acid (TXA) in posterior lumbar interbody fusion (PLIF) can effectively reduce blood loss without affecting coagulation function. However, it has not been reported whether preoperative use of anticoagulants may affect the efficacy of TXA in PLIF. The purpose of this study is to observe the effect of preoperative use of anticoagulants on coagulation indicators and blood loss after PLIF receiving intravenous unit dose TXA. A retrospective analysis was conducted on data from 53 patients with PLIF between 2020.11 and 2022.9, who received intravenous application of a unit dose of TXA (1 g/100 mL) 15 min before the skin incision after general anesthesia. Those who used anticoagulants within one week before surgery were recorded as the observation group, while those who did not use anticoagulants were recorded as the control group. The main observation indicators include surgical time, intraoperative blood loss, postoperative drainage volume, blood transfusion, and red blood cell (RBC), hemoglobin (HB), and hematocrit (HCT) measured on the 1st, 4th, 7th, and last-test postoperative days. Secondary observation indicators included postoperative incision healing, deep vein thrombosis of lower limbs, postoperative hospital stay, and activated partial thrombin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), and platelets (PLT) on the 1st and 4th days after surgery. The operation was successfully completed in both groups, the incision healed well after operation, and no lower limb deep vein thrombosis occurred. There was no significant difference in surgical time, intraoperative blood loss, postoperative drainage volume, and blood transfusion between the two groups (p > 0.05). There was no significant difference in the RBC, HB, and HCT measured on the 1st, 4th, 7th, and last-test postoperative days between the two groups (p > 0.05). There was no statistically significant difference in APTT, PT, TT, FIB and PLT between the two groups on the 1st and 4th postoperative days (p > 0.05). There was no significant difference in postoperative hospital stay between the two groups (p > 0.05). The use of anticoagulants within one week before surgery does not affect the hemostatic effect of intravenous unit dose TXA in PLIF.
摘要：
腰椎后路椎间融合术(PLIF)静脉应用氨甲环酸(TXA)可有效减少失血量,且不影响凝血功能。然而,术前使用抗凝药是否会影响PLIF中TXA的疗效,目前尚无报道.目的观察术前使用抗凝剂对PLIF接受静脉单位剂量TXA后凝血指标及失血量的影响。方法对2020.11～2022.9的53例PLIF患者进行回顾性分析，这些患者在全身麻醉后皮肤切开前15min静脉应用单位剂量TXA（1g/100mL）。将手术前1周内使用抗凝剂的患者记录为观察组,而那些没有使用抗凝剂的人被记录为对照组。主要观察指标包括手术时间、术中失血,术后引流量,输血,和红细胞（RBC），血红蛋白（HB），和1号测量的血细胞比容(HCT)，第四，Seven,以及术后最后一天的测试。次要观察指标包括术后切口愈合,下肢深静脉血栓形成,术后住院时间,和活化的部分凝血酶时间（APTT），凝血酶原时间（PT），凝血酶时间（TT），纤维蛋白原（FIB），术后第1天和第4天的血小板（PLT）。两组手术均顺利完成,手术后切口愈合良好，无下肢深静脉血栓形成。手术时间无显著差异,术中失血,术后引流量,两组间输血情况比较(p>0.05)。RBC无显著差异,HB,1号测量的HCT，第四，Seven,两组患者术后末次试验天数(p>0.05)。APTT差异无统计学意义，PT,TT,术后第1天和第4天两组之间的FIB和PLT（p>0.05）。两组术后住院时间差异无统计学意义(p>0.05)。手术前一周内使用抗凝剂不会影响PLIF中静脉单位剂量TXA的止血效果。
