ZHU Lei, ZHANG Ying, WANG Zhiyuan, TIAN Fang, LU Botao, HAO Dingjun, JIA Shuaijun. Effects of hemostatic gauze and tranexamic acid on perioperative hemorrhage and safety of posterior cervical decompressive laminectomy[J]. Journal of Clinical Medicine in Practice, 2021, 25(12): 32-36. DOI: 10.7619/jcmp.20211663
Citation: ZHU Lei, ZHANG Ying, WANG Zhiyuan, TIAN Fang, LU Botao, HAO Dingjun, JIA Shuaijun. Effects of hemostatic gauze and tranexamic acid on perioperative hemorrhage and safety of posterior cervical decompressive laminectomy[J]. Journal of Clinical Medicine in Practice, 2021, 25(12): 32-36. DOI: 10.7619/jcmp.20211663

Effects of hemostatic gauze and tranexamic acid on perioperative hemorrhage and safety of posterior cervical decompressive laminectomy

More Information
  • Received Date: April 19, 2021
  • Available Online: June 21, 2021
  • Published Date: June 27, 2021
  •   Objective  To compare the effects of intravenous infusion of tranexamic acid and local application of hemostatic gauze on perioperative hemorrhage and safety during posterior cervical decompressive laminectomy.
      Methods  A total of 106 patients with cervical spondylotic myelopathy who underwent posterior cervical laminectomy and decompression were selected as study objects. The patients were randomly divided into tranexamic acid group (n=35), hemostatic group (n=35) and control group (n=36). The control group received conventional treatment, the hemostatic group was implanted hemostatic gauze in the operation area during the operation, and the tranexamic acid group received intravenous infusion of tranexamic acid after the operation. The total blood loss, apparent blood loss, invisible blood loss and postoperative total drainage volume were compared among the three groups. The hemoglobin, hematocrit, platelets, coagulation function indicators and inflammation related indicators of three groups before and 3 days after surgery were compared.
      Results  Total blood loss, apparent blood loss, invisible blood loss and postoperative total drainage in the hemostatic group and tranexamic acid group were significantly less than those in the control group (P < 0.05), and the above indicators of the hemostatic group were also significantly less than those of the tranexamic acid group (P < 0.05). There were no significant differences in the levels of hemoglobin and hematocrit in the three groups at the third postoperative days (P>0.05). The D-dimer and fibrinogen levels at 3 d of the three groups were significantly higher than that of before operation, and the above indicators of the tranexamic acid group were higher than the control group and the hemostatic group (P < 0.05). There were no statistically significant differences in the percentages of white blood cells, neutrophils, and C-reactive protein levels in the three groups at 3 days postoperation (P>0.05).
      Conclusion  The hemostatic effect and safety of hemostatic gauze in posterior cervical decompressive laminectomy are better than those of intravenous drip of tranexamic acid.
  • [1]
    刘学光, 付强, 孙振中, 等. 超声骨刀与高速磨钻在颈椎后路全椎板切除减压手术应用中的比较研究[J]. 中国脊柱脊髓杂志, 2017, 27(6): 539-544. doi: 10.3969/j.issn.1004-406X.2017.06.11
    [2]
    杨乐, 胡方勇. 股骨颈骨折全髋关节置换术中局部应用氨甲环酸的疗效分析[J]. 实用临床医药杂志, 2020, 24(20): 29-32, 36. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202020008.htm
    [3]
    HOWK K, FORTIER J, POSTON R. A novel hemostatic patch that stops bleeding in cardiovascular and peripheral vascular procedures[J]. Ann Vasc Surg, 2016, 31: 186-195. doi: 10.1016/j.avsg.2015.09.007
    [4]
    宋玉铭, 田琨. 颈后路全椎板切除减压治疗颈椎脊髓损伤的临床疗效探讨[J]. 世界复合医学, 2020, 6(4): 69-71. https://www.cnki.com.cn/Article/CJFDTOTAL-SJFH202004023.htm
    [5]
    高景, 杨永斌, 马宏伟, 等. 氨甲环酸对脊柱结核手术出血量和炎症反应的影响[J]. 现代医学, 2014, 42(8): 847-849. https://www.cnki.com.cn/Article/CJFDTOTAL-TDYX201408002.htm
    [6]
    李慧蕴, 王静瑞, 郑向明, 等. 氨甲环酸预防性用药用于颈椎手术患者血液保护的效应[J]. 中华麻醉学杂志, 2017, 37(6): 708-710. doi: 10.3760/cma.j.issn.0254-1416.2017.06.018
    [7]
    刘雅普, 侯秀伟, 胡军华, 等. 氨甲环酸对颈椎后路椎管扩大成形术后减少出血的效果及安全性评估[J]. 实用医药杂志, 2017, 34(4): 309-311. https://www.cnki.com.cn/Article/CJFDTOTAL-QEYY201704008.htm
    [8]
    李欣, 周非非, 张凤山, 等. 颈后路单开门椎管扩大成形术围手术期加速康复外科措施中运用氨甲环酸的效果评估[J]. 中华骨与关节外科杂志, 2019, 12(9): 668-672. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJW201909005.htm
    [9]
    SLEZAK P, MONFORTE X, FERGUSON J, et al. Properties of collagen-based hemostatic patch compared to oxidized cellulose-based patch[J]. J Mater Sci Mater Med, 2018, 29(6): 71. doi: 10.1007/s10856-018-6078-9
    [10]
    MAYER M, MEIER O, AUFFARTH A, et al. Cervical laminectomy and instrumented lateral mass fusion: techniques, pearls and pitfalls[J]. Eur Spine J, 2015, 24(Suppl 2): 168-185. http://europepmc.org/abstract/med/23715892
    [11]
    杨晓, 刘永贵, 杨正东, 等. 止血纱联合氨甲环酸使用减少脑出血术后再发出血的风险[J]. 中外医疗, 2017, 36(25): 142-144. https://www.cnki.com.cn/Article/CJFDTOTAL-HZZZ201725053.htm
    [12]
    张东方, 郑稼. 氨甲环酸对股骨头坏死全髋关节置换术后血栓形成及炎症状况的影响[J]. 实用临床医药杂志, 2019, 23(6): 100-102, 106. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL201906027.htm
    [13]
    冯晨, 周庆忠, 雷飞, 等. 改良全椎板切除结合融合术与单开门椎管扩大成形术治疗多节段脊髓型颈椎病[J]. 西部医学, 2020, 32(8): 1160-1165. https://www.cnki.com.cn/Article/CJFDTOTAL-XIBU202008017.htm
  • Related Articles

    [1]YANG Lei, FENG Yi, WANG Yang. Correlation between preoperative coagulation function and prognosis in patients with hypertensive cerebral hemorrhage undergoing emergency craniotomy[J]. Journal of Clinical Medicine in Practice, 2024, 28(8): 83-87. DOI: 10.7619/jcmp.20240214
    [2]Yisilamujiang·TUERXUN, LI Yuanming, Yelibo·JUNUSIHAN, LIU Wenjuan, ZOU Anqing, Mayirimu·SAIMAITI, CHEN Jiahua. Relationships of coagulation and fibrinolytic functions with patent foramen ovale complicated with cryptogenic stroke[J]. Journal of Clinical Medicine in Practice, 2023, 27(21): 116-119, 124. DOI: 10.7619/jcmp.20231661
    [3]LIU Wei, ZHANG Naiying. Effect of thrombelastogram in monitoring hemostatic and coagulation function in patients undergoing elective orthopedic surgery during blood transfusion[J]. Journal of Clinical Medicine in Practice, 2020, 24(20): 11-14. DOI: 10.7619/jcmp.202020003
    [4]ZHU Wenjuan. Effect of octreotide combined with pantoprazole for elderly patients with peptic ulcer complicating upper gastrointestinal bleeding and its influence on coagulation function[J]. Journal of Clinical Medicine in Practice, 2019, 23(22): 55-57. DOI: 10.7619/jcmp.201922019
    [5]LIU Haodong, FU Xiaowu. Effect of whole-course epidural labor analgesia on coagulation function during vaginal delivery in pregnant women with hypertension[J]. Journal of Clinical Medicine in Practice, 2019, 23(21): 98-100. DOI: 10.7619/jcmp.201921028
    [6]ZHANG Guotao, QIAO Xueli, ZHANG Mingxing. Effect of blood type on coagulation function in parturient women of child-bearing age[J]. Journal of Clinical Medicine in Practice, 2018, (9): 121-123. DOI: 10.7619/jcmp.201809035
    [7]ZHOU Haizhou, HUANG Qianjie, JIANG Hui. Effect of acute super volume blood dilution on cardiac output and blood coagulation function in the senile patients[J]. Journal of Clinical Medicine in Practice, 2017, (3): 123-124,132. DOI: 10.7619/jcmp.201703037
    [8]ZHU Jinli. Effect of urinary kallidinogenase combined with troxerutin and cerebroprotein hydrolysate injection on coagulation and neurological function of patients with acute cerebral infarction[J]. Journal of Clinical Medicine in Practice, 2016, (9): 17-20. DOI: 10.7619/jcmp.201609005
    [9]LIU Yingying, SUN Qiushi. Change of coagulation function and influence of chemotherapy on coagulation function in elderly patients with non-small cell lung cancer[J]. Journal of Clinical Medicine in Practice, 2014, (3): 90-92. DOI: 10.7619/jcmp.201403030
    [10]LI Xiulan. Changes and clinical significances of the blood coagulation function in patients with malignant tumor[J]. Journal of Clinical Medicine in Practice, 2013, (11): 162-164. DOI: 10.7619/jcmp.201311069
  • Cited by

    Periodical cited type(9)

    1. 何瑷芯,赵利华,单俊堂,邹卓成,黄瑜,宁少丽,黄鼎坚. 基于正交设计探讨温和灸对青年人心血管功能及心率变异性的影响. 河北中医. 2025(01): 125-131+136 .
    2. 程玲,汪芳,王伟,谈芮. 多元家庭参与计划下链式亲情护理对老年心血管疾病手术患者的影响. 齐鲁护理杂志. 2024(02): 56-59 .
    3. 王彩霞,薛燕文,吴骏,孙志辉,杜勇平. 社区-家庭一体化的Ⅲ期心脏康复对老年冠心病患者自我效能及运动能力的影响. 检验医学与临床. 2024(02): 166-169 .
    4. 赵汐冉,高寒,武子敬,薛桐,胡泽兵,张舒,郭显. 鸢尾素减轻模拟失重下心肌细胞氧化应激和细胞凋亡. 空军军医大学学报. 2024(02): 152-157+162 .
    5. 袁悦雯,褚欣秋,李阳. 虚拟现实技术在心脏康复运动处方中的应用. 心脑血管病防治. 2024(11): 32-36+41 .
    6. 叶赟,杨柳,张婷,熊朝叶. 分级康复疗养对高海拔地区心血管疾病疗养员心境状态植物神经功能及预后的影响. 安徽医学. 2023(05): 556-560 .
    7. 崔荣,张姝,吴丽英,付琳,张思宁. 运动康复治疗对老年慢性心衰患者生活质量的影响评价. 中外医疗. 2023(14): 36-39+44 .
    8. 牛田瑶,储祥玲,龚倩. 基于运动的心脏康复治疗冠心病的病理生理学研究进展. 中华物理医学与康复杂志. 2023(10): 948-952 .
    9. 林宁宁,赵佳佳,樊俊雅,田欣雨,张辉. 3种治疗方案对经皮冠状动脉介入术患者心功能及预后的影响. 实用临床医药杂志. 2022(16): 66-70 . 本站查看

    Other cited types(4)

Catalog

    Article views (422) PDF downloads (19) Cited by(13)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return