酮咯酸氨丁三醇与帕瑞昔布钠对腰椎经椎间孔入路减压椎间融合手术后出血量的影响

Effects of ketorolac tromethamine and parecoxib sodiumon postoperative blood loss in patients undergoing transforaminal lumbar interbody fusion

  • 摘要:
      目的  探讨酮咯酸氨丁三醇与帕瑞昔布钠对腰椎经椎间孔入路减压椎间融合手术(TLIF)患者术后出血量的影响。
      方法  选取因单节段腰椎管狭窄症行TLIF的59例患者为研究对象,随机分为酮咯酸氨丁三醇组(n=31)与帕瑞昔布钠组(n=28)。酮咯酸氨丁三醇组术后予以酮咯酸氨丁三醇30 mg,静脉滴注,2次/d,共3 d;帕瑞昔布钠组予以帕瑞昔布钠40 mg,静脉推注,2次/d,共3 d。统计2组患者的一般资料、手术时间、术中失血量、术后引流量及显性失血量。检测手术前后血细胞分析、凝血功能、肝肾功能等指标,并计算总失血量及隐性失血量。
      结果  帕瑞昔布钠组总失血量、显性失血量、术后引流量均少于酮咯酸氨丁三醇组,差异有统计学意义(P < 0.05)。帕瑞昔布钠组术后凝血酶原时间及活化部分凝血活酶时间均长于酮咯酸氨丁三醇组,差异有统计学意义(P < 0.05)。
      结论  与酮咯酸氨丁三醇相比,TLIF术后使用帕瑞昔布钠可减少术后总失血量、显性失血量及引流量,但其对隐性失血量影响较小。此外,帕瑞昔布钠可能对凝血功能影响更小。

     

    Abstract:
      Objective  To investigate the effects of ketorolac tromethamine and parecoxib sodium on postoperative blood loss of patients after transforaminal lumbar interbody fusion (TLIF).
      Methods  Fifty-nine patients who underwent TLIF surgery for single-level lumbar spinal stenosis were selected as subjects, and randomly divided into ketorolac tromethamine group (n=31) and parecoxib sodium group (n=28). The ketorolac tromethamine group was given 30 mg of ketorolac tromethamine intravenously, twice a day, for a total of 3 days after surgery, while the parecoxib sodium group was given 40 mg of parecoxib sodium intravenously, twice a day, for a total of 3 days. The general information, operation time, intraoperative blood loss, postoperative drainage volume and dominant blood loss of two groups were counted. The indexes of blood cell analysis, blood coagulation function, liver and kidney function before and after operation were detected, and the total blood loss and latent blood loss were calculated.
      Results  The total blood loss, dominant blood loss and postoperative drainage volume in the parecoxib sodium group were significantly less than those in the ketorolac tromethamine group (P < 0.05). Postoperative prothrombin time and activated partial thromboplastin time in the parecoxib sodium group were significantly longer than those in the ketorolac tromethamine group (P < 0.05).
      Conclusion  Compared with ketorolac tromethamine, the use of parecoxib sodium after TLIF can reduce postoperative total blood loss, dominant blood loss and drainage volume, but it has little effect on latent blood loss. In addition, parecoxib sodium may have less effect on blood coagulation function.

     

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