中国骨伤2026，Vol.39Issue(5)：466-472,7.DOI:10.12200/j.issn.1003-0034.20250035
氨甲环酸联合可吸收流体明胶在单节段腰椎经椎间孔椎间融合术围术期止血作用研究
Hemostatic efficacy of tranexamic acid combined with absorbable fluid hemostat in single-level transforaminal lum-bar interbody fusion during the perioperative period
摘要
Abstract
Objective To compare the effect of intravenous tranexamic acid(TXA)combined with local application of gelatin sponge versus intravenous TXA combined with absorbable fluid hemostat(SurgifloTM)on perioperative blood loss in pa-tients undergoing single-level transforaminal lumbar interbody fusion(TLIF).Methods A retrospective analysis was conducted on the clinical data of 64 patients undergoing single-segment TLIF between September 2023 and September 2024.The control group comprised 32 patients who received intravenous TXA infusion combined with local gelatin sponge hemostasis during the perioperative period,including 14 males and 18 females,aged 49 to 70 years with a mean of(60.47±5.93)years.The affected segments were as follows:L2,3 in 1 case,L3,4 in 6 cases,L4,5 in 13 cases,and L5S1 in 12 cases.The observation group consisted of 32 patients receiving intravenous TXA infusion combined with local SurgifloTM hemostasis,including 15 males and 17 females,aged 49 to 69 years with a mean of(59.59±5.35)years.The affected segments were:L2,3 in 1 case,L3,4 in 7 cases,L4,5 in 12 cases,and L5S1 in 12 cases.Compare and observe the preoperative and postoperative changes in hematocrit(HCT)and hemoglobin(HGB)levels between the two groups;the total blood volume,intraoperative blood loss,total postoperative drainage volume,perioperative total blood loss,extubation time,and operative duration were compared between the two groups.Results All patients were followed up,and the duration ranged from 2 to 3 months,with a mean of(2.10±0.57)months.The observation group showed significantly higher HCT levels at postoperative days 1 and 3,and higher HGB levels at postoperative day 3 compared to the control group(all P＜0.05).The intraoperative blood loss in the observation group was(230.16±22.98)mL,significantly lower than that in the control group(250.63±22.09)mL,with a statistically significant difference(P＜0.05).The observation group exhibited significantly lower perioperative total blood loss(907.29±270.13)mL and postoperative drainage volume(199.06±19.49)mL compared to the control group(1 166.73±269.13)mL and(211.19±20.75)mL,respec-tively,with statistically significant differences(P＜0.05).The extubation time(2.56±0.50)days and operative duration(161.25±14.87)minutes in the observation group were significantly shorter than those in the control group(3.03±0.65)days and(172.50±15.24)minutes,respectively,with a statistically significant difference(P＜0.05).Multiple linear regression anal-ysis identified the use of SurgifloTM as the most significant predictor of reduced total perioperative blood loss(β=-0.550,P＜0.001).Conclusion Compared with the combination of intravenous TXA and gelatin sponge,the use of intravenous TXA com-bined with local SurgifloTM in single-level TLIF significantly reduces postoperative drainage and perioperative blood loss,short-ens both operation time and extubation time,without increasing the risk of wound complications or deep vein thrombosis.关键词
氨甲环酸/腰椎/脊柱融合术/手术期间出血/可吸收明胶海绵Key words
Tranexamic acid/Lumbar vertebrae/Spinal fusion/Intraoperative hemorrhage/Gelatin sponge,ab-sorbable分类
医药卫生引用本文复制引用
李焕玺,田志敏,何淳诺,单兴宇,王宏达,高杰,张浩强..氨甲环酸联合可吸收流体明胶在单节段腰椎经椎间孔椎间融合术围术期止血作用研究[J].中国骨伤,2026,39(5):466-472,7.基金项目
兰州市人才创新创业项目(编号:2023-2-28) （编号:2023-2-28）
联勤保障部队第九四〇医院院内科研基金(编号:2021YXKY014)Lanzhou Talent Innovation and Entrepreneurship Project(No.2023-2-28) （编号:2021YXKY014）
