摘要
目的探讨大剂量氨甲环酸对老年颈椎后路椎板成形侧块螺钉内固定融合术的出血影响和安全性。方法对2016年6月至2018年6月在北京医院因颈椎病行老年颈椎后路椎板成形侧块螺钉内固定融合术的患者(年龄>60岁)62例,采用随机双盲抽签法分为2组,各31例。对照组采用常规治疗,观察组在常规治疗的基础上加用1. 5 g氨甲环酸注射液治疗。对患者术中失血量、术后引流量、术中引流天数和术中输血量、住院时间等指标进行比较。结果观察组术中出血量[(191±58)mL vs.(271±32)mL,t=-6. 712,P<0. 001]、术后引流量[(120±35)mL vs.(150±38)mL,t=-3. 231,P<0. 01]、术后引流天数[(1. 19±0. 40)d vs.(1. 65±0. 70)d,t=-3. 081,P<0. 01]和术中输血量[(0. 13±0. 34)U vs.(0. 42±0. 50)U,t=-2. 666,P=0. 01]较对照组均下降;观察组术后住院时间短于对照组[(5. 97±1. 11)d vs.(7. 23±1. 18)d,t=-4. 333,P<0. 001],差异均有统计意义。结论大剂量氨甲环酸能明显减少老年多节段颈椎后路椎板成形侧块螺钉内固定融合术围手术期失血量及输血量。
Objective To investigate the effect and safety of high-dose tranexamic acid on bleeding of posterior laminoplasty with lateral mass screw internal fixation in elderly patients. Methods From June 2016 to June 2018,a prospective control study was carried out in the elderly patients with cervical spondylosis(age > 60 years old)underwent posterior laminoplasty with lateral mass screw internal fixation and fusion in Beijing Hospital. The patients were randomly divided into two groups.The control group was treated with conventional therapy,while the experimental group was transfused with 1. 5 g tranexamic acid on the basis of conventional therapy. The volume of intraoperative blood loss,postoperative drainage volume,days of intraoperative drainage,intraoperative blood transfusion volume,and hospital stay were compared. Results The volume of intraoperative blood loss in the experimental group was significantly lower than that in the control group[(191±58)mL vs.(271±32)mL,t=-6. 712,P<0. 001];the volume of postoperative drainage in the experimental group was significantly lower than that in the control group[(120±35)mL vs.(150±38)mL,t=-3. 231,P<0. 01];the intraoperative drainage days in the experimental group was significantly lower than that in the control group[(1. 19±0. 40)d vs.(1. 65±0. 70)d,t=-3. 081,P<0. 01];the amount of intraoperative blood transfusion in the experimental group was significantly lower than that in the control group[(0. 13±0. 34)U vs.(0. 42±0. 50)U,t=-2. 666,P=0. 01];the hospital stay in the experimental group was significantly shorter than that in the control group[(5. 97±1. 11)d vs.(7. 23±1. 18)d,t=-4. 333,P<0. 001]. the differences above were significant between the two groups(all P≤0. 01).Conclusion High-dose tranexamic acid can significantly reduce the perioperative blood loss and transfusion volume of the elderly patients with posterior laminoplasty with lateral mass screw internal fixation and fusion.
作者
尹自龙
薛庆云
YIN Zi-long;XUE Qing-yun(Department of Orthopedics,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《临床药物治疗杂志》
2020年第6期35-38,共4页
Clinical Medication Journal
关键词
氨甲环酸
颈椎侧块螺钉
颈椎病
出血
tranexamic acid
cervical lateral mass screw
cervical spondylosis
hemorrhage
