| 单次给药法静滴氨甲环酸对双节段后路腰椎椎间融合术后白细胞与红细胞沉降率及C反应蛋白的影响 |
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投稿时间：2023-09-24
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| 作者 | Author | 单位 | Address | E-Mail |
| 郝申申 |
HAO Shen-shen |
平煤神马医疗集团总医院脊柱骨科骨肿瘤科, 河南 平项山 467000 |
Department of Spine and Bone Tumor, General Hospital of Pingmei Shenma Medical Group, Pingdingshan 467000, Henan, China |
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| 安晓龙 |
AN Xiao-long |
延安市人民医院骨科, 陕西 延安 716000 |
Department of Orthopaedics, Yan'an People's Hospital, Yan'an 716000, Shaanxi, China |
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| 董胜利 |
DONG Sheng-li |
平煤神马医疗集团总医院脊柱骨科骨肿瘤科, 河南 平项山 467000 |
Department of Spine and Bone Tumor, General Hospital of Pingmei Shenma Medical Group, Pingdingshan 467000, Henan, China |
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| 刘帅 |
LIU Shuai |
平煤神马医疗集团总医院脊柱骨科骨肿瘤科, 河南 平项山 467000 |
Department of Spine and Bone Tumor, General Hospital of Pingmei Shenma Medical Group, Pingdingshan 467000, Henan, China |
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| 李洪珂 |
LI Hong-ke |
平煤神马医疗集团总医院脊柱骨科骨肿瘤科, 河南 平项山 467000 |
Department of Spine and Bone Tumor, General Hospital of Pingmei Shenma Medical Group, Pingdingshan 467000, Henan, China |
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| 王鹏程 |
WANG Peng-cheng |
平煤神马医疗集团总医院脊柱骨科骨肿瘤科, 河南 平项山 467000 |
Department of Spine and Bone Tumor, General Hospital of Pingmei Shenma Medical Group, Pingdingshan 467000, Henan, China |
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| 张韶民 |
ZHANG Shao-min |
平煤神马医疗集团总医院四肢骨科, 河南 平项山 467000 |
Department of Limb Orthopaedics, General Hospital of Pingmei Shenma Medical Group, Pingdingshan 467000, Henan, China |
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| 康凯 |
KANG Kai |
延安大学附属医院脊柱骨科, 陕西 延安 716000 |
Department of Spine, Affiliated Hospital of Yan'an University, Yan'an 716000, Shaanxi, China |
www20160812@163.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第10期，第978-984页 |
| DOI：10.12200/j.issn.1003-0034.20221121 |
| 基金项目:平煤神马集团总医院科研项目(编号:4104022021180717);延安市重点研发计划项目(编号:2021YF-19);延安市人民医院培育基金项目(编号:2022PY-08) |
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中文摘要:
目的: 观察单次给药法静滴氨甲环酸(tranexamic acid,TXA)在双节段后路腰椎椎间融合术(posterior lumbar interbody fusion,PLIF)中的安全性与有效性,并探讨围术期的白细胞(white blood cell,WBC)、红细胞沉降率(erythrocyte sedimentation rate,ESR)和C反应蛋白(C-reactive protein,CRP)的变化及趋势。
方法: 自2020年10月至2022年9月,采用双节段PLIF治疗了46例腰椎退行性疾病患者,其中男18例,女28例,年龄34~80(60.24±10.68)岁。根据治疗方法不同分为观察组和对照组。观察组28例,男12例,女16例;年龄(61.04±9.03)岁;腰椎间盘突出症(lumbar disc herniation, LDH)3例,腰椎管狭窄症(lumbar spinal stenosis, LSS)18例,腰椎滑脱症(lumbar spondylolisthesis, LS)7例;在全身麻醉后切皮前15 min开始一次性静滴TXA(1 g/100 ml)。对照组18例,男6例,女12例;年龄(59.00±13.04)岁;LDH 5例,LSS 9例,LS 4例;不使用TXA。记录两组手术时间、术中出血量、术后引流量、术后下肢深静脉血栓形成(deep vein thrombosis,DVT)、术后住院时间、活化部分凝血酶原时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,FIB)、血小板(platelet,PLT)、红细胞(red blood cell,RBC)、血红蛋白(hemoglobin,HB)、红细胞压积(hematocrit,HCT),术后第1、4、7天和末次测量的WBC、ESR和CRP。
结果: 术后患者伤口愈合良好,均无DVT。46例患者获随访,时间3~6个月。观察组术中出血量400.0(300.0,500.0) ml、术后引流量260.0 (220.0,450.0) ml,低于对照组600.0 (400.0,1 000.0) ml及395.0(300.0,450.0) ml(P＜0.05)。两组手术时间、术后住院时间,术后APTT、PT、TT、FIB、PLT、RBC、HB、HCT,术后不同时间WBC、ESR和CRP比较,差异均无统计学意义(P＞0.05)。
结论: 采用单次给药法静滴TXA可减少双节段PLIF失血,且对术后的WBC、ESR和CRP无显著影响。 |
| 【关键词】双节段后路腰椎椎间融合术 氨甲环酸 失血量 |
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| Observation of the effect of single dose intravenous infusion of tranexamic acid on white blood cell,erythrocyte sedimentation rate and C-reactive protein after double segmental posterior lumbar interbody fusion |
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ABSTRACT
Objective To observe the safety and effectiveness of single dose intravenous infusion of tranexamic acid (TXA) in dual level posterior lumbar interbody fusion (PLIF),and to explore the changes and trends in perioperative white blood cell (WBC),erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP).
Methods Between October 2020 and September 2022,46 patients with lumbar degenerative disease were treated with dual level PLIF,including 18 males and 28 females,with an average age of (60.24±10.68) years old,from 34 to 80 years old. They were divided into observation group and control group according to different treatment methods. There were 28 patients in the observation group,including 12 males and 16 females,with an average age of (61.04 ±9.03) years old. There were 3 cases with lumbar disc herniation (LDH),lumbar spinal stenosis (LSS) 18 cases,lumbar spondylolisthesis (LS) 7 cases. TXA (1 g/100 ml) was administered intravenously 15 min before skin incision after general anesthesia. The control group consisted of 18 patients,including 6 males and 12 females,with an average age of (59.00±13.04) years old. There were 5 cases with LDH,LSS 9 cases,LS 4 cases,and TXA was not used. The operation time,intraoperative bleeding volume,postoperative drainage volume,postoperative deep vein thrombosis (DVT),postoperative hospital stay,postoperative activated partial thromboplastin time (APTT),prothrombin time (PT),thrombin time (TT),fibrinogen (FIB),platelet (PLT),red blood cell (RBC),hemoglobin (HB),hematocrit (HCT),the first day,the fourth day,the seventh day and the last tested after operation WBC,ESR and CRP were recorded..
Results The postoperative wounds of the patients healed well and there was no DVT. 46 patients were followed up from 3 to 6 months. The intraoperative blood loss was 400.0 (300.0,500.0) ml and the postoperative drainage was 260.0 (220.0, 450.0) ml in the observation group,which were lower than the control group[600.0(400.0,1000.0) ml,395.0 (300.0,450.0) ml],P＜0.05. There was no significant difference between the two groups in operation time,postoperative hospital stay,postoperative APTT,PT,TT,FIB,PLT,RBC,HB,HCT,and postoperative WBC,ESR and CRP at different times (P＞0.05).
Conclusion Single dose intravenous infusion of TXA can reduce the blood loss of bi-segmental PLIF,and has no significant effect on WBC,ESR and CRP after operation. |
| KEY WORDS Double level posterior lumbar interbody fusion Tranexamic acid Blood loss |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 郝申申,安晓龙,董胜利,刘帅,李洪珂,王鹏程,张韶民,康凯.单次给药法静滴氨甲环酸对双节段后路腰椎椎间融合术后白细胞与红细胞沉降率及C反应蛋白的影响[J].中国骨伤,2024,37(10):978~984 |
| 英文格式: | HAO Shen-shen,AN Xiao-long,DONG Sheng-li,LIU Shuai,LI Hong-ke,WANG Peng-cheng,ZHANG Shao-min,KANG Kai.Observation of the effect of single dose intravenous infusion of tranexamic acid on white blood cell,erythrocyte sedimentation rate and C-reactive protein after double segmental posterior lumbar interbody fusion[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(10):978~984 |
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