摘要
目的探讨云南白药联合氨甲环酸对胸腰椎骨折手术患者隐性失血量和凝血功能的影响。方法选取2018年6月~2019年11月经XX医院行经椎间孔胸椎间融合术(transforaminal thoracic interbody fusion, TTIF)治疗的116例胸腰椎骨折患者作为研究对象,采用随机数字表法分为中西结合组和西药组,每组各58例。比较两组患者术中输血和失血情况以及手术前后的凝血功能水平。结果中西结合组术中输血量、隐性失血量、显性失血量、总失血量以及术后24h引流量均较西药组降低,差异具有统计学意义(P<0.05);术后6周内,中西医结合组共发生血栓事件2例,发生率为3.45%,均为下肢深静脉血栓(DVT),西药组共发生血栓事件8例,发生率为13.79,其中下肢深静脉血栓(DVT)7例,肺栓塞(PE)1例。组间比较,中西结合组术后3个月内的血栓事件发生率相比西药组降低,差异具有统计学意义(χ^(2)=4.182,P=0.041)。而两组患者在术前3d、术后24h和术后72h的D-D、Fib以及FDP水平差异均无统计学意义(P>0.05)。结论 TXA在减少胸腰椎骨折手术患者术中出血和隐性出血有一定的效果,与云南白药合用不仅可以增强止血效果,更能有效降低术后血栓事件的发生风险。
Objective To investigate the effect of yunnan baiyao combined with tranexamic acid on the latent blood loss and coagulation function in thoracolumbar fracture patients.Methods 116 patients with thoracolumbar fracture who underwent transforaminal thoracic interbody fusion(TTIF) in XX hospital from June, 2018 to November, 2019 were selected as the study subjects.Intraoperative blood transfusion and blood loss as well as coagulation function before and after operation were compared between the two groups.Results The amount of intraoperative blood transfusion, implicit blood loss, dominant blood loss, total blood loss and postoperative drainage rate were all lower in the combined group than in the western group(P<0.05).Within 6 weeks after the operation, 2 patients in the integrated traditional Chinese and western medicine group had thrombotic events, with an incidence rate of 3.45%,all of whom were lower limb deep vein thrombosis(DVT),and 8 patients in the western medicine group had thrombotic events, with an incidence rate of 13.79,including 7 cases of lower limb deep vein thrombosis(DVT) and 1 case of pulmonary embolism(PE).Compared with the western medicine group, the incidence of thrombus events within 3 months after surgery in the western medicine group was significantly lower than that in the western medicine group(χ^(2)=4.182,P=0.041).However, there was no statistically significant difference in d-d, Fib and FDP levels between the two groups at 3 days before surgery, 24 hours after surgery and 72 hours after surgery(P>0.05).Conclusion TXA has a certain effect on reducing intraoperative hemorrhage and latent hemorrhage in patients undergoing thoracolumbar fracture surgery.The combination of TXA and yunnan baiyao can not only enhance the hemostasis effect, but also effectively reduce the risk of postoperative thrombus events.
作者
孔祥涛
Kong Xiangtao(Xinxiang second people's hospital xinxiangy,Henan 453000)
出处
《辽宁医学杂志》
2021年第2期29-32,共4页
Medical Journal of Liaoning
关键词
胸腰椎骨折
经椎间孔胸椎间融合术
隐性失血
凝血功能
Thoracolumbar fracture
Transforaminal thoracic fusion
Recessive blood loss
Blood coagulation function
