| 氨甲环酸对脑脊索瘤切除术围术期出血量的影响：一项随机对照研究 |
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| 引用本文： | 氨甲环酸对脑脊索瘤切除术围术期出血量的影响：一项随机对照研究.氨甲环酸对脑脊索瘤切除术围术期出血量的影响：一项随机对照研究[J].首都医学院学报,2023,44(2):289-294. |
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| 作者姓名： | 氨甲环酸对脑脊索瘤切除术围术期出血量的影响：一项随机对照研究 |
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| 作者单位： | 首都医科大学附属北京天坛医院麻醉科，北京 100070 |
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| 基金项目： | 北京市医院管理局“登峰”人才培养计划(DFL20180502） |
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| 摘 要： | 目的 探讨氨甲环酸对于内镜下切除颅底脊索瘤患者术中出血量的影响以及应用的安全性。方法 选取2021年7月15日至2022年10月27日首都医科大学附属北京天坛医院行经内镜颅底脊索瘤切除术治疗的患者58例。采用数字表法随机将患者分为氨甲环酸组30例和0.9%(质量分数)氯化钠注射(以下简称生理盐水)对照组28例。氨甲环酸组于手术切皮时给予氨甲环酸总量为20 mg/kg负荷量泵注，泵注时长为15 min,随后按5 mg·kg-1·h-1连续泵注至手术结束或药物用尽，且药物总量不超过2 g。生理盐水组则以等量同速的生理盐水泵注。记录术中失血量、术中及术后输血、手术时长、患者术后24h凝血相关指标、术后并发症、非计划二次手术、重症加强护理病房(intensive care unit, ICU)停留、住院时长。结果 氨甲环酸组术中失血量明显少于生理盐水组4.2(3.1,10.0)mL/kg vs 6.4(4.3, 13.2)mL/kg,P<0.05];两组患者术中输血率差异无统计学意义(P>0.05);术后氨甲环酸组输血率明显少于生理盐水...
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| 关 键 词： | 颅底脊索瘤 氨甲环酸 术中出血 |
| 收稿时间： | 2023-02-21 |
Effect of intraoperative tranexamic acid application on bleeding in patients undergoing endoscopic resection of skull base chordoma |
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| Jing Longnian,Lei Cheng,Yao Jingxin,Han Ruquan.Effect of intraoperative tranexamic acid application on bleeding in patients undergoing endoscopic resection of skull base chordoma[J].Journal of Capital University of Medical Sciences,2023,44(2):289-294. |
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| Authors: | Jing Longnian Lei Cheng Yao Jingxin Han Ruquan |
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| Affiliation: | Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China |
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| Abstract: | Objective To investigate the effect of tranexamic acid on intraoperative bleeding in patients with endoscopic resection of skull base chordoma and the safety of its application. Methods Fifty-eight patients who underwent transendoscopic skull base chordoma resection from July 15, 2021 to October 27, 2022 at Beijing Tiantan Hospital, Capital Medical University were selected. The patients were divided into 30 cases in the tranexamic acid group （ group T） and 28 cases in the 0.9% sodium chloride injection control group （ group C） using the random number table method. In group T, tranexamic acid was administered at a loading dose of 20 mg/kg for 15 min at the time of surgical skin incision, followed by continuous pumping at 5 mg·kg－1·h－1 till the end of surgery or till the drug was exhausted, and the total amount of drug did not exceed 2 g. In group control, saline was pumped at the same rate and in the same amount. Intraoperative blood loss, intraoperative and postoperative blood transfusion, duration of surgery, patient coagulation-related indexes at 24 h postoperatively, postoperative complications, unplanned secondary surgery, intensive care unit (ICU） stay, and length of hospital stay were recorded. Results Intraoperative blood loss in group T was significantly less than that in group C ［4.2 (3.1, 10.0) mL/kg versus 6.4 (4.3, 13.2) mL/kg, P<0.05］. The intraoperative transfusion rate was not different with statistically significance between the two groups (P>0.05). However, the postoperative transfusion rate in the group T was significantly less than that in the control group (P<0.05). There were no statistically significant differences in the length of surgery, postoperative 24 h coagulation-related indexes, postoperative complications, unplanned secondary surgery, ICU stay or length of hospitalization between the two groups. ConclusionIntraoperative tranexamic acid in patients undergoing endoscopic resection of skull base chordoma was effective in reducing intraoperative bleeding and postoperative transfusion rates without increasing the incidence of postoperative complications. |
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