Effect of Tranexamic Acid on Hidden Blood Loss in Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: A Retrospective Study

IF 2.8 3区医学 Q1 Pharmacology, Toxicology and Pharmaceutics

Therapeutics and Clinical Risk Management Pub Date : 2024-05-29 DOI:10.2147/tcrm.s462784

Yanlei Li, Meng Ge, Jinlong Tian, Jinlei Zhou, Yao Kang, Chen Xia, Haiyu Shao, Yongguang Wang, Yazeng Huang, Tingxiao Zhao

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引用次数: 0

Abstract

Purpose: Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has become one of the most popular minimally invasive surgeries today. However, the issue of hidden blood loss (HBL) in this surgery has received little attention. This study aims to examine the HBL in PE-TLIF surgery and the effect of tranexamic acid (TXA) on blood loss.
Methods: In our research, We conducted a retrospective analysis of 300 patients who underwent PE-TLIF from September 2019 to August 2023. They were divided into 2 groups based on whether they received intravenous TXA injection before surgery. The variables compared included: demographic data, pre-and postoperative hemoglobin (HB), hematocrit (HCT), platelets (PLT), red blood cells (RBC), total blood loss (TBL), visible blood loss (VBL), HBL, operation time, postoperative hospital stay, inflammatory markers, coagulation parameters, and adverse events.
Results: Regarding demographic characteristics, besides the operation time, no significant differences were observed between the two groups. Compared with the control group, the TXA group showed a significant reduction trend in TBL, HBL, and VBL (P < 0.05). On the first day after surgery, there were significant differences in prothrombin (PT), activated partial thromboplastin time (APTT), and D-dimer (D-D) levels between the two groups. Similarly, HCT also found similar results on the third day after surgery. No adverse events occurred in either group.
Conclusion: Research has found that there is a significant amount of HBL in patients undergoing PE-TLIF. Intravenous injection of TXA can safely and effectively reduce perioperative HBL and VBL. Additionally, compared to the control group, the TXA group shows a significant reduction in operation time.

Keywords: percutaneous endoscopic transforaminal lumbar interbody fusion, tranexamic acid, total blood loss, visible blood loss, hidden blood loss

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氨甲环酸对经皮内窥镜经椎间孔腰椎椎体间融合术隐性失血的影响：回顾性研究

目的：经皮内窥镜经椎间孔腰椎椎体融合术（PE-TLIF）已成为当今最流行的微创手术之一。然而，该手术中的隐性失血（HBL）问题却鲜有人关注。本研究旨在探讨 PE-TLIF 手术中的隐性失血以及氨甲环酸（TXA）对失血的影响：在研究中，我们对 2019 年 9 月至 2023 年 8 月期间接受 PE-TLIF 的 300 例患者进行了回顾性分析。根据术前是否静脉注射 TXA 将患者分为两组。比较的变量包括：人口统计学数据、术前和术后血红蛋白（HB）、血细胞比容（HCT）、血小板（PLT）、红细胞（RBC）、总失血量（TBL）、可见失血量（VBL）、HBL、手术时间、术后住院时间、炎症指标、凝血指标和不良事件：在人口统计学特征方面，除手术时间外，两组间无明显差异。与对照组相比，TXA 组的 TBL、HBL 和 VBL 有明显下降趋势（P < 0.05）。术后第一天，两组间凝血酶原（PT）、活化部分凝血活酶时间（APTT）和 D-二聚体（D-D）水平有显著差异。同样，HCT 在术后第三天也发现了相似的结果。两组均未发生不良事件：研究发现，接受 PE-TLIF 手术的患者体内存在大量的 HBL。结论：研究发现，PE-TLIF 患者体内存在大量的 HBL，而静脉注射 TXA 可以安全有效地减少围手术期的 HBL 和 VBL。关键词：经皮内镜经椎间孔腰椎椎体融合术；氨甲环酸；总失血量；可见失血量；隐性失血量

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

5.30

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.