文章摘要
胡仲翔,张继学,孟祥晖,张志军,王磊,段文.氨甲环酸用于脊柱转移性肿瘤手术安全性及有效性分析[J].中国临床保健杂志,2018,21(6):794-797.
氨甲环酸用于脊柱转移性肿瘤手术安全性及有效性分析
The analysis of safety and effectiveness of tranexamic acid on the surgery for spinal metastatic tumors
投稿时间:2018-08-10  
DOI:10.3969/J.issn.1672-6790.2018.06.018
中文关键词: 脊椎肿瘤  神经外科手术  氨甲环酸  有效性研究
英文关键词: Spinal neoplasms  Neurosurgical procedures  Tranexamic acid  Validation studies 〖FL
基金项目:
作者单位E-mail
胡仲翔 安徽省肿瘤医院骨与软组织肿瘤科,合肥 230031 huzx1986@126.com 
张继学 安徽省肿瘤医院骨与软组织肿瘤科,合肥 230031  
孟祥晖 安徽省肿瘤医院骨与软组织肿瘤科,合肥 230031  
张志军 安徽省肿瘤医院骨与软组织肿瘤科,合肥 230031  
王磊 安徽省肿瘤医院骨与软组织肿瘤科,合肥 230031  
段文 安徽省肿瘤医院骨与软组织肿瘤科,合肥 230031  
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中文摘要:
      目的 探讨氨甲环酸应用于脊柱转移性肿瘤围手术期的安全性及有效性。方法 选取行胸腰椎转移性骨肿瘤手术的患者共80例,其中男性43例、女性37例,男女患者按照随机数字法分为氨甲环酸组、对照组两组,每组40例。氨甲环酸组在切开前静脉给予10 mg/kg的氨甲环酸,随后给予2 mg·kg-1·h-1的维持量。对照组给予同等量的0.9%氯化钠注射溶液作为对照。比较两组术中失血量,术前术后血红蛋白差值,患者输血比例以及深静脉血栓和肺动脉栓侧发生率。结果 氨甲环酸组术中出血量[(479.25±104.37) mL]明显少于对照组[(827.38±135.85)mL],差异有统计学意义(P<0.05)。氨甲环酸组术后72 h血红蛋白变化值[(11.41±1.47)g/L]明显少于对照组[(12.70±1.14)g/L],差异有统计学意义(P<0.05)。两组患者输血比例,术后发生深静脉血栓,住院时间比较差异无统计学意义(P>0.05),两组术后均无严重出血及肺栓塞等严重并发症。结论 通过氨甲环酸在脊柱转移性肿瘤手术中的应用可以明显降低术中出血量及血红蛋白变换值,并且不增加下肢深静脉血栓及肺栓塞的发生率,有良好的药物安全性。
英文摘要:
      Objective To explore the safety and efficacy of tranexamic acid during perioperative period of spinal metastatic tumor.Methods A total of 80 patients with spinal metastases for surgery in our hospital from January 2017 to May 2018 were selected,including 43 males and 37 females.Male and female patients were randomly allocated to receive the tranexamic acid and the placebo,with 40 patients in each group.In the tranexamic acid group,Patients were administered 10mg/kg of tranexamic acid intravenously before the incision,followed by an infusion of 2 mg·kg-1·h-1 till the end of surgery.In the control arm,the patient receives an identical volume of normal saline that is indistinguishable from the intervention.The intraoperative blood loss,preoperative and postoperative hemoglobin differences,the proportion of blood transfusion,and the incidence of deep venous thrombosis and pulmonary embolism were compared between the two groups.Results The intraoperative blood loss(479.25±104.37 mL) and the changes of the hemoglobin concentration[(11.41±1.47)g/L] were significantly lower than those in the placebo group[(827.38±135.85)mL][(12.70±1.14)g/L].There was no statistical significance in comparing the difference among the hospitalization time,the proportion of blood transfusion and deep vein thrombosis after surgery.There were no serious perioperative complications,such as serious bleeding events,pulmonary embolism and so on (P>0.05).Conclusion The application of tranexamic acid during the operation of spinal metastases could significantly reduce the intraoperative bleeding and hemoglobin transformation value without increasing the incidence of deep venous thrombosis and pulmonary embolism of lower limbs.
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