Large Doses Of Tranexamic Acid Reduces Blood Loss In Spinal Surgery

Objective:Explore to use large doses of tranexamic acid can reduce blood loss in spine surgery.Methods:Patients who need massive blood transfusion randomly divided into two groups. Before operation 15-30 minutes,the patients assigned to TXA received an intravenous bolus dose of 100mg/kg,followed by 10mg/kg per h for the duration of surgery,B group is placebo.When volume of blood loss reach to 30% blood-volume in operation,we infuse concentrated red blood cell and fresh frozen plasma,and keep intraoperative haemoglobin levels above 70g/L.When volume of blood loss reach to one blood-volume,we infuse platelet and cryoprecipitate.CVP was keep in 5-10cmH2O during the whole operation.Put patient into SICU with tracheal catheter after operation.Whether or not ooze blood from the wound surface was recorded,blood routine examination,blood clotting function,post-operative creatinine and ventilator support time are monitored. Patients were followed up until discharge.Results:①There are no significant differences in APTT,Fib,TT,Plt,bodyweight,blood-volume,creatinine,albumuin of preoperative and operation-time between the two groups (P>0.05);②In the tranexamic acid group, blood loss was reduced compared with placebo (1700±1950ml vs.4950±6263ml;P< 0.05); The amount of allogeneic red blood cell transfused was reduced (740.0±735.4ml vs.2562±1885ml, P<0.05).③It do not come forth after-transfusion infection.There is no significant difference in postoperative drainage(P>0.05). No apparent intravascular thrombosis occurred in any patient.Conclusion:①In group A,TXA can reduce blood loss,blood and fluid transfusion.②It do not come forth after-transfusion infection.There is no significant difference in postoperative drainage.③The incidence of intravascular thrombosis with use of TXA has not been occurred.There is no significant difference in postoperative creatinine.