Comparative Study On The Perioperative Effect Of Tranexamic Acid On Degenerative Lumbar Spinal Stenosis

Objective To analyze and compare the effects of single and repeated intravenous tranexamic acid on perioperative blood loss in patients with bipartite Lumbar Stenosis.Methods Retrospective analysis was conducted on the patients who received the first double-level posterior lumbar interbody fusion in Guo long Hospital from January 2018 to December 2020.According to different medication and meeting the inclusion criteria,113 patients were divided into group A(n= 40),group B(n=35)and group C(n=38).Single administration group(group A)was intravenously dripping tranexamic acid 1g+100ml saline15 minutes before surgical dermectomy;multiple administration group(group B)was intravenously dripping tranexamic acid return to room after surgery on the basis of group A;control group(group C without TXA)was intravenously dripping the same amount of normal saline at the same time point.The differences of age,gender,body mass index,ASA grade,surgical segment,hemoglobin(Hb),hematocrit(HCT),platelet(PLT),dominant blood loss,intraoperative blood loss,postoperative drainage volume,blood transfusion and thrombosis among the three groups were compared.Results There were no significant differences in gender,age,body mass index and surgical segment among the three groups.There were no significant differences in erythrocyte,hematocrit and platelet between the three groups before and after surgery(P>0.05).In group A and B,intraoperative blood loss(278.62 ±94.70 m L,264.46±38.30 m L),dominant blood loss(563.77±114.03 m L,487.11±34.44 m L),postoperative drainage volume(285.15±50.39 m L,222.65±16.59 m L)and in group C,intraoperative blood loss(478.15 ± 120.04 m L),dominant blood loss(943.15 ± 180.97 m L),postoperative drainage volume(465.00 ±142.66ml)and the difference was statistically significant(P<0.05),but there was no statistical significance in the amount of intraoperative blood loss between group A and group B(P>0.05).The postoperative drainage volume in group B was significantly less than that in group A,and the difference was statistically significant(P<0.05).No Deep Vein Thrombosis(DVT),Pulmonary Embolism(PE)and hematoma formation occurred in the three groups after operation.Conclusion 1.Intravenous tranexamic acid can effectively reduce perioperative blood loss after posterior lumbar interbody fusion.2.Tranexamic acid can reduce blood transfusion events in lumbar posterior surgery and has a positive effect on preventing blood loss in patients.3.Preoperative and intraoperative intravenous administration of tranexamic acid has better hemostatic effect than single administration.4.Intravenous tranexamic acid did not increase the incidence of perioperative complications after lumbar spinal stenosis.