Effect Analysis of Preoperative Intravenous Tranexamic Acid Combined With Intraoperative Immersion in Reducing Perioperative Blood Loss of One Stage Posterior Thoracolumbar Tuberculosis

Frontiers in Surgery

article

Guohua Lv¹  Jing Li¹  Jingyu Wang¹  Bowen Zheng¹  Boyv Zheng³  Huaqing Niu³  Xiaobin Wang¹ 

[1] Department of Spine Surgery, The Second Xiangya Hospital of Central South University;Musculoskeletal Tumor Center, Peking University People's Hospital, Peking University;Department of Orthopedics Surgery, General Hospital of the Central Theater Command

关键词: thoracolumbar tuberculosis;    tranexamic acid;    blood loss;    local immersion;    drainage;   

DOI  :  10.3389/fsurg.2022.852589

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background To investigate the efficacy and safety of preoperative intravenous tranexamic acid (TXA) combined with intraoperative immersion in reducing perioperative blood loss in one-stage posterior thoracolumbar tuberculosis. Methods All patients were divided into four groups: Group A received an intravenous drip of TXA before surgery, group B received multiple local immersions during the operation, group C received an intravenous drip combined with multiple local immersions, and the control group (group CG) were not treated with TXA during the same period. The total blood loss (TBL), intraoperative blood loss (IBL), hidden blood loss (HBL), postoperative drainage volume, maximum hemoglobin drop value (max Hb drop), liver and kidney function, coagulation indexes, blood transfusion rate, hospital stay and incidence of complications were compared among the four groups. Results TBL, IBL, HBL, max Hb drop, POD1 drainage, and POD2 drainage in group A, group B, and group C were significantly lower than those in group CG. TBL, IBL, HBL and max Hb drop were group C < group A < group B < group CG. The drainage volume of group C was significantly lower than that of the other groups. There was no significant difference in blood coagulation index (PT, D-D) or liver and kidney function (ALT, Cr) among the four groups. There was no difference in postoperative hospital stay between group A and group B, but it was significantly lower in group C than in the other three groups. All patients achieved satisfactory bone graft fusion at the last follow-up. Conclusion Preoperative intravenous drip of TXA combined with intraoperative multiple immersion can effectively reduce perioperative blood loss while not increasing the risk of thrombosis without affecting liver and kidney function, coagulation function or tuberculosis prognosis.

【 授权许可】

CC BY