Abstract：
Scoliosis is the most prevalent type of spinal deformity, with a 2-3% prevalence in the general population. Moreover, surgery for scoliotic deformity may result in severe blood loss and, consequently, the need for blood transfusions, thereby increasing surgical morbidity and the rate of complications. Several antifibrinolytic drugs, such as tranexamic acid, have been regarded as safe and effective options for reducing blood loss. Therefore, the present study aimed to analyse the effectiveness of this drug for controlling bleeding when used intraoperatively and in the first 48 h after surgery. A prospective randomized study of a cohort of patients included in a mass event for scoliosis treatment using PSF was performed. Twenty-eight patients were analysed and divided into two groups: 14 patients were selected for intraoperative and postoperative use of tranexamic acid (TXA), and the other 14 were selected only during the intraoperative period. The drainage bleeding rate, length of hospital stay, number of transfused blood units, and rate of adverse clinical effects were compared. All the patients involved had similar numbers of fusion levels addressed and similar scoliosis profiles. The postoperative bleeding rate through the drain did not significantly differ between the two groups (p > 0.05). There was no significant difference in the number of transfused blood units between the groups (p = 0.473); however, in absolute numbers, patients in the control group received more transfusions. The length of hospital stay was fairly similar between the groups, with no statistically significant difference. Furthermore, the groups had similar adverse effects (p = 0.440), with the exception of nausea and vomiting, which were twice as common in the TXA group postoperatively than in the control group. No significant differences were found in the use of TXA during the first 48 postoperative hours or in postoperative outcomes.
摘要：
脊柱侧凸是脊柱畸形最常见的类型,在一般人群中患病率为2-3%。此外，手术治疗脊柱侧弯畸形可能导致严重的失血，因此,需要输血,从而增加手术发病率和并发症的发生率。几种抗纤维蛋白溶解药物，如氨甲环酸，被认为是减少失血的安全有效的选择。因此,本研究旨在分析该药术中和术后48h内控制出血的有效性。进行了一项前瞻性随机研究，该研究包括使用PSF治疗脊柱侧凸的大量事件中的一组患者。对28例患者进行分析并分为两组：选择14例患者进行术中和术后使用氨甲环酸（TXA），其他14例仅在术中选择。引流出血率,住院时间,输血单位数,并比较临床不良反应发生率。所有涉及的患者都有相似的融合水平和相似的脊柱侧凸特征。两组患者术后引流管出血率差异无统计学意义(p>0.05)。两组之间的输血单位数没有显着差异（p=0.473）；然而，在绝对数字上，对照组患者接受更多输血.两组之间的住院时间相当相似，差异无统计学意义。此外，两组有相似的不良反应（p=0.440），除了恶心和呕吐，TXA组术后发生率是对照组的两倍。在术后前48小时内使用TXA或术后结局没有显着差异。
