| Objective: The purpose of this study was to investigate the efficacy and safety of oral tranexamic acid in reducing perioperative blood loss in patients with degenerative lumbar spinal stenosis,so as to promote its use in more surgical methods and more patients.Methods: Patients admitted to Loudi Central Hospital from January2019 to November 2020 who were diagnosed with lumbar spinal stenosis and planned to undergo posterior lumbar interbody fusion surgery were selected as the research subjects..According to the set inclusion and exclusion criteria,data of 80 patients were finally collected,including 47 males and 33 females,aged38～67 years old,average age 52.13 ± 5.73 years old,height 149～178cm,average height 163.13±7.05 cm.Body weight is 53～81kg,average body weight is 67.66±6.43 kg,body mass index is 23.8～26.3kg/m~2,average BMI25.36±0.53kg/m~2.These 80 patients were enrolled in A cohort study,in which the patients admitted from December 2019 to November 2020 and planned to undergo posterior lumbar interbody fusion were assigned as TXA group(Group A,n=40),and the patients admitted from January 2019 to November 2019 and planned to undergo posterior lumbar interbody fusion were assigned as control group(Group B,n=40).Patients in group A received TXA 1.0g orally 2h before surgery,6h after surgery,and 12 h after surgery,respectively,while patients in group B did not receive TXA.The collected data were statistically analyzed by SPSS19.0 software,and P < 0.05 indicated statistically significant differences.Results: All the collected patient data were statistically analyzed,and there was no significant difference between the TXA group and the control group in the general data of patients undergoing fusion operation at each level,with a P value of > 0.05.In the TXA group,the total blood loss was(351.97±28.54ml),the intraoperative blood loss was(201.29 ± 17.59ml),and the postoperative blood loss was(150.68±12.33ml),the drainage volume within24 h after operation(161.33 ± 16.33ml)and the drainage volume before extubation 24 h after operation(72.50±14.36ml)were significantly lower than those in the control group(568.50 ± 21.28 ml,277.89 ± 15.93 ml,290.61 ±7.90 ml,247.19 ± 14.83 ml and 157.33 ± 15.83ml),and the differences were statistically significant(P < 0.05).Among the patients undergoing double-level fusion surgery,TXA group had total blood loss(620.13 ± 19.34ml),intraoperative blood loss(296.94±16.73ml),postoperative blood loss(323.19±5.54ml),drainage volume 24 h after surgery(272.13±17.24ml),and drainage volume 24 h after surgery to before extubation(191.56 ± 15.63ml)were significantly lower than those in the control group(781.17±64.92 ml,351.69±14.56 ml,429.48 ± 69.59 ml,329.85 ± 13.33 ml and 249.46 ± 14.10ml),with statistical significance(P < 0.05).No postoperative complications such as lower extremity deep vein thrombosis and pulmonary embolism occurred in all patients.Conclusions: Oral tranexamic acid can effectively reduce perioperative blood loss in patients with degenerative lumbar spinal stenosis,and does not increase the incidence of postoperative complications such as lower extremity deep vein thrombosis and pulmonary embolism. |
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