本研究旨在观察氨甲环酸(TXA)在腰椎后路双节段椎间融合术(PLIF)中的止血和抗炎作用。本研究包括53例接受双节段PLIF治疗的腰椎疾病患者的数据。观察组在全麻后皮肤切开前15min单剂量静脉注射TXA(1g/100mL)。对照组不接受TXA。观察指标包括术后活化部分凝血酶原时间(APTT),凝血酶时间(PT),凝血酶时间(TT),纤维蛋白原(FIB),血小板(PLT),术后下肢深静脉血栓形成,手术时间,术中出血量,术后引流量,输血率,术后住院时间,红细胞(RBC),血红蛋白(HB),血细胞比容(HCT),C反应蛋白(CRP),和红细胞沉降率(ESR)在1日,第四,Seven,手术后的最后一天测试。所有患者均顺利完成手术,术后无下肢深静脉血栓形成。术后APTT无统计学差异,PT,TT,FIB,PLT,手术时间,术后住院时间两组比较(p>0.05)。术中出血量,术后引流量,观察组输血率均低于对照组,差异均有统计学意义(p<0.05)。RBC差异无统计学意义,HB,HCT,CRP,和ESR在1号两组之间,第四,Seven,和手术后最后一天测试(p>0.05)。双节段PLIF静脉给予TXA不影响凝血功能,可减少出血量,术后引流量,输血率。此外,不影响术后炎症反应。
This study aims to observe the hemostatic and anti-inflammatory effects of intravenous administration of tranexamic acid (TXA) in dual segment posterior lumbar interbody fusion (PLIF). The data of 53 patients with lumbar disease treated with double-segment PLIF were included in this study. The observation group was received a single-dose intravenous of TXA (1 g/100 mL) 15 min before skin incision after general anesthesia. The control group was not received TXA. The observation indicators included postoperative activated partial prothrombin time (APTT), thrombin time (PT), thrombin time (TT), fibrinogen (FIB), platelets (PLT), and postoperative deep vein thrombosis in the lower limbs, surgical time, intraoperative bleeding volume, postoperative drainage volume, transfusion rate, postoperative hospital stay, red blood cell (RBC), hemoglobin (HB), hematocrit (HCT), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) on the 1st, 4th, 7th, and last tested day after surgery. All patients successfully completed the operation, and there was no deep vein thrombosis after operation. There was no statistically significant difference in postoperative APTT, PT, TT, FIB, PLT, surgical time, and postoperative hospital stay between the two groups (p > 0.05). The intraoperative bleeding volume, postoperative drainage volume, and transfusion rate in the observation group were lower than those in the control group, and the differences were statistically significant (p < 0.05). There was no statistically significant difference in RBC, HB, HCT, CRP, and ESR between the two groups on the 1st, 4th, 7th, and last tested day after surgery (p > 0.05). Intravenous administration of TXA in dual segment PLIF does not affect coagulation function and can reduce bleeding volume, postoperative drainage volume, and transfusion rate. Moreover, it does not affect the postoperative inflammatory response.