氨甲环酸不同给药途径在一期后路胸椎结核手术中的应用
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篇名: 氨甲环酸不同给药途径在一期后路胸椎结核手术中的应用
TITLE:
摘要: 目的:观察氨甲环酸不同给药途径对一期后路胸椎结核手术患者凝血功能和出血量的影响。方法:选择我院2011年1月-2013年12月胸椎结核患者40例,按随机数字表法分为静脉组(5%葡萄糖注射液100 ml+氨甲环酸10 mg/kg,在关闭伤口前30 min静脉滴注)和局部组(5%葡萄糖注射液10 ml+氨甲环酸10 mg/kg,在关闭伤口前将局部伤口置于其中浸泡5 min),各20例;另选我院2009年1月-2010年12月的胸椎结核患者15例作为对照组。3组患者均行一期后路结核病灶清除、植骨融合、椎弓根螺钉内固定术,观察患者手术前后血红蛋白差值、凝血功能及引流管引流液量,并进行随访,观察植骨融合及结核治疗情况。结果:静脉组和局部组患者术后引流液量比较差异无统计学意义(P>0.05),但均较对照组明显减少,差异有统计学意义(P<0.05)。3组患者的纤维蛋白酶原、凝血酶原时间和活化部分凝血酶原时间比较,差异无统计学意义(P>0.05)。对照组患者手术前后血红蛋白差值明显高于静脉组和局部组,差异有统计学意义(P<0.05),但静脉组与局部组患者之间比较差异无统计学意义(P>0.05)。所有55例患者均得到随访,患者植骨块均得到融合,胸椎结核均治愈、无复发。结论:静脉及局部应用氨甲环酸均可以明显降低胸椎结核患者术后出血量,减轻其贫血程度,且不影响凝血功能。
ABSTRACT: OBJECTIVE: To observe the effects of different routes of administration of tranexamic acid on coagulation function and amount of bleeding in patients with one stage posterior surgery of thoracic tuberculosis. METHODS: 40 patients suffered from thoracic tuberculosis in our hospital from Jan. 2011 to Dec. 2013 were randomly divided into intravenous group (5% Glucose injection 100 ml+tranexamic acid 10 mg/kg, through an intravenous drip at 30 min before closing the wound) and topical application group (5% Glucose injection 10 ml and tranexamic acid 10 mg/kg, through soaking the wound before closing the wound) with 20 cases in each group. Other 15 cases suffered from the thoracic tuberculosis in our hospital from Jan. 2009 to Dec. 2010 were included in control group. 3 groups received one stage posterior surgery of thoracic tuberculosis, interbody fusion and internal fixation. The difference of hemoglobin, coagulation function and the amount of suction drainage were observed before and after surgery, and followed up. Bone graft fusion and therapeutic condition of tuberculosis were observed in the study. RESULTS: There was no statistical significance in postoperative suction drainage between intravenous group and topical application group (P>0.05), but their decrease was more significant than control group, with statistical significance (P<0.05). There was no statistically difference in fiber protease, prothrombin time or activated partial thromboplastin time among 3 groups (P>0.05). The difference value of hemoglobin in control group before and after operation was significantly higher than in intravenous group and topical application group, with statistical significance (P<0.05); there was no statistical significance between intravenous group and topical application group (P>0.05). 55 patients were all followed up and bone graft of all cases were fused, and all patients were cured and no case recurred. CONCLUSIONS: Tranexamic acid by intravenous application or topical application can reduce hemorrhage and anemia after operation of thoracic tuberculosis, and has no effect on blood coagulative system.
期刊: 2016年第27卷第5期
作者: 路坦,刘晓潭,张超,董玉珍,赵斌
AUTHORS: LU Tan,LIU Xiaotan,ZHANG Chao,DONG Yuzhen,ZHAO Bin
关键字: 胸椎结核;氨甲环酸;给药途径;一期后路
KEYWORDS: Thoracic tuberculosis; Tranexamic acid; Route of administration; One stage posterior
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