Effects Of Different Methods Of Tranexamic Acid Administration On Blood Loss Of Patients After Posterior Lumbar Inter Body Fusion

ObjectiveThis study explored the clinical efficacy and safety of tranexamic acid for blood loss after lumbar fusion and provided clinical evidence for it,and also provided reference for clinicians.MethodsThe data of patients with perioperative hemorrhage of PLIF treated with TXA in the Guangdong Provincial Hospital of Traditional Chinese Medicine from 2017 to 2019 were collected and divided into group A(33 cases,TXA via intravenous injection(IV)),group B(43 cases,TXA via intravenous injection(IV)and injection)and group C(45 cases,TXA via injection).Gender,age,body mass index,and preoperative HGB,Hct,prothrombin time,and activated partial prothrombin time,intraoperative hemorrhage,postoperative incision drainage,HGB or Hct at l,3,and 7 days after surgery,transfusion rate,visible blood loss,hidden blood loss and total blood loss,as well as thromboembolic complications were observed.All patients were routinely observed for deep vein thrombosis(DVT)by the color Doppler ultrasonography after operation,and the symptomatic pulmonary embolism(PE)were observed.After data collection,statistics and analysis were done using SPSS 19.0 and R 3.5.2 software.ResultsThere was no significant difference in HGB and Hct at 1,3,and 7 days after operation between 3 groups(P>0.05).There was no significant difference in the extubation time,transfusion rate and the length of hospital stay between 3 groups(P>0.05).The postoperative drainage volume,intraoperative blood loss and visible or hidden blood loss as well as total blood loss were significantly less in group B than that in groups A and C(P<0.05),whereas no difference was found between groups A and C(P>0.05).And there was no DVT or symptomatic PE in 3 groups.ConclusionPosterior lumbar interbody fusion with application of TXA via intravenous injection(IV)and injection can significantly reduce the visible blood loss,hidden blood loss and total blood loss,and is safe without adverse reactions.