静脉应用氨甲环酸在椎体成形术治疗骨质疏松性椎体压缩性骨折中的安全性和有效性

目的探讨氨甲环酸(TXA)在老年患者双侧入路椎体成形术治疗骨质疏松性椎体压缩性骨折中的安全性和有效性.方法行双侧入路椎体成形术的骨质疏松性椎体压缩性骨折的老年患者124例,按TXA的应用情况分为两组,其中静脉TXA组66例,空白对照组58例.主要观察指标为术后死亡率、血栓率、出血率;次要观察指标为术后切口感染率、渗出率、血肿发生率和住院时间.结果主要指标方面,静脉TXA组的出血发生率明显降低,而不增加血栓发生率和死亡率.次要指标方面,与对照组患者比较,TXA组的渗出率降低,术后感染率减低,围手术期住院时间减少,血肿率有降低趋势,但差异无统计学意义.结论 TXA对老年人行双侧入路的椎体成形术治疗骨质疏松性椎体压缩性骨折中具有诸多益处,可降低围手术期的伤口感染、渗出和出血,减少住院时间,而并不增加患者血栓发生率.

Efficacy and Safety of Intravenous Injection of Tranexamic Acid in Percutaneous Vertebroplasty for the Treatment of Osteoporotic Vertebral Compression Fracture

Objective To explore the efficacy and safety of intravenous injection of tranexamic acid ( TXA) during percutaneous vertebroplasty ( PVP ) in elderly patients with osteoporotic vertebral compression fracture. Method A total of 124 elderly patients undergoing PVP were divided into two groups according to the inclusion and exclusion criteria. There were 66 patients in TXA group and 58 patients in the control group. The primary outcomes were stroke, systemic embolism, bleeding and mortality. The secondary outcomes were incision infection,exudation, hematoma and hospital stay. Results For the outcome of bleeding, there was significant difference between TXA group and the control group. There were no notable differences between the two groups in the rates of stroke,systemic embolism and mortality. Similarly,there were significant differences between the two groups in the rates of incision infection,exudation,and hospital stay,but no significant difference was found in the rate of hematoma. Conclusion Elderly patients with osteoporotic vertebral compression fracture receiving TXA treatment during PVP exhibited a decline in the rates of incision infection,exudation and bleeding,and similar in the time of hospital stay. Furthermore,it did not increased the rate of stroke or systemic embolism.