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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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

Received: 06 January 2021

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