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首页> 外文期刊>BMC Musculoskeletal Disorders >Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery
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Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery

机译：疏松酸在青少年特发性脊柱侧凸手术中同种异体血液产物中的疗效

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Background Adolescent idiopathic scoliosis (AIS) surgery usually require prolonged operative times with extensive soft tissue dissection and significant perioperative blood loss, and allogeneic blood products are frequently needed. Methods to reduce the requirement for transfusion would have a beneficial effect on these patients. Although many previous studies have revealed the efficacy of tranexamic acid (TXA) in spinal surgery, there is still a lack of agreement concerning the reduction of both blood loss and transfusion requirements of large dose tranexamic acid (TXA) in surgery for adolescent idiopathic scoliosis (AIS). The objective of this study was to elevate the efficacy and safety of a large dose tranexamic acid (TXA) in reducing transfusion requirements of allogeneic blood products in adolescent idiopathic scoliosis (AIS) surgery using a retrospective study designed with historical control group. Methods One hundred thirty seven consecutive AIS patients who underwent surgery treatment with posterior spinal pedicle systems from August 2011 to March 2015 in our scoliosis center were retrospectively reviewed. Patients were divided into two groups, the TXA group and the historical recruited no TXA group (NTXA). Preoperative demographics, radiographic parameters, operative parameters, estimated blood loss (EBL), total irrigation fluid, number of patients requiring blood transfusion, mean drop of Hb (Pre-op Hb-Post-op Hb), haematocrit pre and post-surgery, mean volume of blood transfusion, hospitalization time, and adverse effect were recorded and compared. Results All the patients were successfully treated with satisfied clinical and radiographic outcomes. There were 71 patients in the TXA group and 66 patients in the NTXA group. The preoperative demographics were homogeneity between two groups ( P >?0.05). There were no significant difference in average operative time between two groups (209?min vs 215?min, p >0.05). Number of patients in the TXA group showed a significant decrease in transfusion requirements with an associated reduced intraoperative blood loss of nearly 45% compared with those in NTXA group (8 vs37, 619?ml vs 1125?ml, P 0.05). Additional, patients in NTXA group showed significant decrease of Hb compared with patients in TXA group (5.2?g/dL vs 3.3?g/dL, P ?0.05). No minor adverse effects associated with use of TXA were noted. Conclusions Use of large dose tranexamic acid routinely seems to be effective and safe in reducing allogenic blood transfusion and blood loss in adolescent idiopathic scoliosis surgery.
机译：背景技术青少年特发性脊柱侧凸（AIS）手术通常需要长时间的手术时间，具有广泛的软组织解剖和显着的围手术失血，并且经常需要同种异体血液产品。减少输血要求的方法对这些患者有益效果。虽然以前的许多研究揭示了冬季蛋白酸（TXA）在脊柱手术中的疗效，但仍然缺乏关于青少年特发性脊柱侧凸术治疗大剂量Tranexamic酸（TXA）的血液损失和输血要求的缺乏协议（ AIS）。本研究的目的是提高大剂量促进剂（TXA）的疗效和安全性，以降低青少年特发性脊柱侧凸（AIS）手术中同种异体血液产物的输血要求使用历史对照组的回顾性研究。方法回顾性审查2011年8月2011至2015年3月从2011年8月到2015年8月从脊柱椎弓根系统接受手术治疗的一百三十七名连续AIS患者。患者分为两组，TXA组和历史招募没有TXA组（NTXA）。术前人口统计学，射线照相参数，手术参数，估计失血（EBL），总灌溉液，需要输血的患者数量，平均滴过HB（op HB-PHER-OP HB），血细胞比容前和手术后，记录和比较了均值的输血，住院时间和不良影响。结果所有患者均已成功治疗满足临床和放射线摄影结果。 TXA组中有71名患者，NTXA组66名患者。术前人口统计学是两组之间的均匀性（P> 0.05）。两组之间的平均手术时间没有显着差异（209？min与215？min，p> 0.05）。 TXA组患者的数量表现出输血要求的显着降低，与NTXA组中的术术失血有近45％的相关性降低（8 Vs37,619？ml，p

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