Abstract：
Spine surgeries are associated with significant blood loss due to the extensive soft tissue dissection, bony decompression, and prolonged surgical time. Excessive bleeding may require blood transfusions and thereby increase the risk of adverse transfusion reactions. Therefore, minimizing peri-operative bleeding is important for spine surgeons to reduce post-operative morbidity. Tranexamic acid (TXA) is a synthetic anti-fibrinolytic drug, which helps in reducing perioperative blood loss in major surgeries. The evidence on the efficacy of this agent in all manner of spine surgeries is not sufficient. Hence this study was conducted to determine the efficacy of TXA on perioperative blood loss in major spinal surgeries. In a prospective study, two groups of patients with similar surgical profiles who were posted for all manner of open spine surgeries were included. One group received one gram of intravenous TXA while the others did not. Intra- and post-operative assessments included noting levels of surgery, duration of surgery, assessment of blood loss, intra- and/or post- operative blood transfusion, and blood collected in surgical drain at the end of 24 h. The intra-operative blood loss, frequency of intra-operative blood transfusion, post-operative Hemoglobin drop, and surgical drain output were found to be significantly lower in patients who received TXA. In spine surgeries, TXA was found to be effective in reducing intra-operative blood loss, need for intra-operative blood transfusion and post-operative Hb drop. Also, TXA had reduced surgical drain output significantly between the two groups.
摘要：
由于广泛的软组织解剖，脊柱手术与大量失血有关，骨减压,延长手术时间。过度出血可能需要输血，从而增加输血不良反应的风险。因此,减少围手术期出血对脊柱外科医生降低术后发病率很重要.氨甲环酸（TXA）是一种合成的抗纤维蛋白溶解药物，这有助于减少大型手术围手术期的失血。关于这种药物在所有方式的脊柱手术中的功效的证据是不充分的。因此，本研究旨在确定TXA对大型脊柱手术围手术期失血的疗效。在一项前瞻性研究中，包括两组手术概况相似的患者，这些患者被张贴在各种方式的脊柱开放手术中。一组接受1克静脉内TXA，而另一组则没有。术中和术后评估包括记录手术水平，手术持续时间,失血评估,术中和/或术后输血,并在24小时结束时收集在手术引流中的血液。术中失血，术中输血的频率，术后血红蛋白下降,发现接受TXA的患者的手术引流输出显着降低。在脊柱手术中，TXA可有效减少术中失血，术中输血和术后Hb下降的需要。此外，TXA在两组之间显着减少了手术引流输出。
