老年人行颈后路双开门椎管扩大成形术围术期使用氨甲环酸的安全性及疗效评估

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摘要目的评估老年人行颈后路双开门椎管扩大成形术围术期使用氨甲环酸的安全性及疗效。方法选取2018年1月—2020年2月在赣南医学院第一附属医院脊柱外科行颈后路双开门椎管扩大成形术的66 例老年患者（年龄≥60 岁）作为研究对象，根据围术期是否使用氨甲环酸，分为氨甲环酸组（35 例）和对照组（31 例）。对照组患者接受常规处理，氨甲环酸组患者在对照组处理基础上术前、术后加用1 g 氨甲环酸。比较两组术中出血量、手术时间、术后第1 天引流量、术后第2 天至拔管总引流量、术后第3 天血红蛋白浓度、围术期隐性出血量、围术期总出血量、围术期输血情况及并发症发生率。结果氨甲环酸组围术期总出血、隐性出血量及术后第1 天引流量均少于对照组，差异有统计学意义（P＜0.05）。氨甲环酸组术后血红蛋白浓度高于对照组，差异有统计学意义（P＜0.05）。氨甲环酸组围术期输血率（14.3%）低于对照组（38.7%），差异有统计学意义（P＜0.05）。两组手术时间、术中出血量、术后第2 天至拔管总引流量及术后血栓相关并发症发生率比较，差异无统计学意义（P＞0.05）。结论老年人行颈后路双开门椎管扩大成形术围术期使用氨甲环酸可以减少术后出血及围术期隐性出血，维持血红蛋白，减少异体输血，不增加血栓风险。

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关键词 ：老年人, 氨甲环酸, 颈椎, 双开门椎管扩大成形术, 出血量

Abstract：Objective To evaluate the safety and efficacy of Tranexamic Acid used in the elderly patients undergoing posterior cervical double-door laminoplasty during perioperative period.Methods A total of 66 elderly patients (age ≥60 years old) who underwent posterior cervical double-door laminoplasty in Department of Spine Surgery of the First Affiliated Hospital of Gannan Medical University from January 2018 to February 2020 were selected as the research subjects.The patients were divided into Tranexamic Acid group(35 cases)and control group(31 cases)according to Whether or not Tranexamic Acid was used during perioperative period.Control group received routine treatment, on the basis of the treatment of the control group,patients in the Tranexamic Acid group were given 1 g Tranexamic Acid before and after operation.The intraoperative blood loss, operating time, drainage amount in the first postoperative day, total drainage amount from the second day to extubation, hemoglobin on the third day after operation, perioperative hidden blood loss,total perioperative blood loss, the incidence of allogeneic blood transfusion and incidence of complications were compared between the two groups.Results The total perioperative blood loss, perioperative hidden blood loss and drainage amount in the first postoperative day of the Tranexamic Acid group were less than those in the control group, and the differences were statistically significant (P＜0.05).The concentration of hemoglobin after operation in the Tranexamic Acid group was higher than that in the control group, and the difference was statistically significant (P＜0.05).The incidence of allogeneic blood transfusions in Tranexamic Acid group(14.3%)was lower than that in the control group(38.7%),and the difference was statistically significant (P＜0.05).No significant differences were found in intraoperative blood loss, operating time, total drainage amount from the second day to extubation and the incidence of postoperative thrombosis-related complications between the two groups (P＞0.05).Conclusion Tranexamic Acid used in the elderly patients undergoing posterior cervical double-door laminoplasty can reduce postoperative blood loss, perioperative hidden blood loss and allogeneic blood transfusion, maintain hemoglobin level and without increasing the risk of thrombosis.

Key words： Elderly Tranexamic Acid Cervical spine Cervical double-door laminoplasty Blood loss

收稿日期: 2021-01-06

基金资助:江西省教育厅科技青年项目（GJJ170883）

引用本文:

钟艳春；欧阳训彦；叶勇军；刘午阳. 老年人行颈后路双开门椎管扩大成形术围术期使用氨甲环酸的安全性及疗效评估[J]. 中国当代医药, 2021, 28(20): 92-95.
ZHONG Yan-chun OUYANG Xun-yan YE Yong-jun LIU Wu-yang. Evaluation on the safety and efficacy of Tranexamic Acid used in the elderly patients during perioperative period of posterior cervical doubledoor laminoplasty. 中国当代医药, 2021, 28(20): 92-95.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I20/92

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