不同负压引流方式联合氨甲环酸对颈椎后路单开门手术病人失血量、引流量及并发症的影响

目的 探究不同负压引流方式联合氨甲环酸对颈椎后路单开门手术的多节段脊髓型颈椎病病人失血量、引流量及并发症的影响。方法 按照研究目标设定的纳入、排除标准，将2018年10月至2020年10月沧州中西医结合医院接受颈椎后路单开门手术的多节段脊髓型颈椎病病人182例作为研究对象进行回顾性研究，根据负压引流情况分为A组（持续负压引流联合氨甲环酸，46例）、B组（间断负压引流联合氨甲环酸，46例）、C组（持续负压引流，不使用氨甲环酸，45例）及D组（间断负压引流，不使用氨甲环酸，45例）。对比四组病人手术时间、总失血量、术后引流量、术后72 h血红蛋白水平，生化指标活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、纤维蛋白原（Fib）]，术后疼痛视觉模拟评分（VAS）及日本骨科协会评估治疗分数（JOA）评分。结果 手术后，四组手术时间、总失血量比较差异无统计学意义（P>0.05），四组术后24 h引流量A组（191.21±22.38）mL、B组（175.34±17.85）mL、C组（205.62±20.78）mL、D组（210.43±20.14）mL]、术后隐性失血量A组（27...

Effects of different negative pressure drainage methods combined with tranexamic acid on blood loss, drainage volume and complications in patients with posterior cervical single-door surgery

Objective To explore the effect of different negative pressure drainage methods combined with tranexamic acid on theblood loss, drainage volume and complications of multisegmental cervical spondylotic myelopathy patients undergoing posterior cervi-cal single-door surgery.Methods According to the inclusion and exclusion criteria set by the research objectives, a total of 182 pa-tients of multisegmental cervical spondylotic myelopathy, who underwent cervical posterior single door operation in Cangzhou Hospitalof Integrated Traditional and Western Medicine from October 2018 to October 2020, were selected as research subjects for a retrospec-tive study. They were assigned into group A (continuous negative pressure drainage combined with tranexamic acid, 46 cases), group B(intermittent negative pressure drainage combined with tranexamic acid, 46 cases), group C (continuous negative pressure drainagewithout using tranexamic acid, 45 cases) and group D (intermittent negative pressure drainage without using tranexamic acid, 45 cases)according to the negative pressure drainage. The operation time, total blood loss, postoperative drainage volume, 72 h postoperative he-moglobin level, biochemical indexes activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib)], postopera-tive pain visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were compared among the four groups.Re. sults After the operation, there were no significant differences in the operation time and total blood loss among the 4 groups (P>0.05).Drainage volumes at 24 hours after operation group A: (191.21±22.38) mL, group B: (175.34±17.85) mL, group C: (205.62±20.78) mL,group D: (210.43±20.14) mL], postoperative hidden blood loss group A: (275.37±30.12) mL, group B: (251.42±26.12) mL, group C:(321.47±35.62) mL, group D: (296.78±32.14)mL], and indwelling time of drainage tube group A: (1.85±0.51) d, group B: (1.45±0.42)d, group C: (2.32±0.65) d, group D: (2.78±0.78) d] were found to be statistically different (P<0.05), among which group B was the best,followed by group A. The hemoglobin levels at 72 hours after operation in all groups group A: (112.43±12.57) g/L, group B: (120.53±17.85) g/L, group C: (103.47±10.78) g/L, group D: (102.58±11.12) g/L] were significantly decreased (P<0.05), with group B droppingthe least, followed by group A. The differences in serum APTT, PT and Fib levels among the four groups were statistically significant (P <0.05), among which the changes of all indicators in group A were the most obvious, and the serum APTT level in group B changed theleast. There were no significant differences in VAS and JOA scores among the four groups (P>0.05). And there were no significant dif-ferences in fever, cerebrospinal fluid leakage, hematoma compression, deep vein thrombosis of lower extremities, cardiovascular eventsand other complications among the four groups (P>0.05).Conclusion The application of intermittent negative pressure drainage com-bined with tranexamic acid in posterior cervical single door surgery can shorten the operation time, reduce the postoperative drainagevolume and hidden blood loss, and improve the hemoglobin level.