局部应用氨甲环酸在脊柱外科手术中的安全性和有效性研究

目的探讨局部应用不同浓度氨甲环酸在脊椎外科手术中的安全性和有效性.方法建立脊椎后路减压动物模型,随机将模型动物分成生理盐水组(A)、氨甲环酸25 mg/m L组(B)、氨甲环酸50 mg/m L组(C)和氨甲环酸100 mg/m L组(D),在术后1,3,7 d观察大鼠行为学运动变化及体感诱发电位变化;同时观察止血效果,统计各组的出血量.结果行为学中发现高浓度氨甲环酸100 mg/m L组在术后7 d的运动能力恢复较差,体感诱发电位中潜伏期延长,波幅降低;氨甲环酸50 mg/m L组运动能力恢复较好,体感诱发电位中潜伏期缩短,波幅延长;上述两组止血效果相当,均优于生理盐水组和氨甲环酸25 mg/m L组.结论 50 mg/m L的氨甲环酸止血效果好,安全.

On Efficacy and Safety of Local Application of Tranexamic Acid in Spine Surgery

Objective To assess the efficacy and safety of different doses of tranexamic acid ( TXA ) in spine surgery. Method Spinal posterior decompression models were established in rats. And the rats were randomly divided into 4 groups ( n=15 each ):control group ( group A, normal saline ) , tranexamic acid group B ( concentration:25 mg/mL) ,tranexamic acid group C ( concentration:50 mg/mL) and tranexamic acid group D (concentration:100 mg/mL). All the rats were implemented with posterior spine surgery,and their movement change,somatosensory evoked potential,blood loss,postoperative complications were observed at the day 1,3,7 after operation. Results Compared with group C ( 50 mg/mL ) , the rats in group D ( 100 mg/mL ) showed worse,longer somatosensory evoked potential latency prolonged and lower amplitude. The hemostatic effects of group C and group D were the same,and were both better than the other two groups. Conclusion TXA in the concentration of 50 mg/mL shows good hemostatic effect and safety.