Effects Of Tranexamic Acid And Hemocoagulase On Coagulation In Patients Undergoing Liver Hydatid Hepatectomy In High Altitude

ObjectivesHepatic echinococcosis is a common disease among nomads in northwest China.The key to success of liver surgery is to control the blood loss and maintain the normal blood coagulation function.Because hepatic echinococcosis mostly occurs in the Tibetan people who live in the environment of hypoxia at high altitude for a long time,they have special constitution different from that at low altitude.Hemostatic drugs in the use of liver hydatid surgery also lack a lot of research data,this research mainly studies tranexamic acid and hemocoagulase on high altitude blood coagulation function in patients with hepatic partial resection of liver echinococcosis and the effect of study at high altitudes,intraoperative bleeding of drug varieties,dosage,timing,and whether to reduce intraoperative blood transfusion,save resources,blood of patients with blood coagulation function and effect of fibrinolytic function.MethodsThis study collected 65 Tibetan patients who underwent partial liver resection of liver hydatid(right hemihepatectomy)under general anesthesia from October 2018 to December 2019,ages 18 to 70 years,ASA Ⅱ ～ Ⅳ,Child-Pugh A ～ B level,normal preoperative coagulation function.The subjects were randomly divided into group A(sodium chloride injection group),group B(tranexamic acid injection group)and group C(hemagglutinin injection group).Group A received 10 m L 0.9% Na Cl injection intravenously at 0.5h before surgery,group B received 10 m L TXA injection of 10mg/kg intravenously at 0.5h before surgery,and group C received 10 m L hemocoagulase injection of 2 units at 0.5h before surgery.Conclusion: Preoperative administration of 10 mg/kg tranexamic acid and 2 units of hemocoagulase did significantly reduce intraoperative bleeding and the dosage of suspended red blood cells and fresh frozen plasma.All statistic analyses were performed using commercially available software for IBM SPSS 22.0.ResultsPart 1:The postoperative Hb(g/L)and PLT(×10^9 /L)levels of group A were significantly lower than group B,and group C,P<0.05.Intraoperative blood loss(m L),erythrocyte infusion(m L)and plasma infusion(m L)in group A were significantly higher than group B,and group C,P<0.05.There was no significant difference between group B and group C(P>0.05).Part 2:Postoperative APTT(s),PT(s),TT(s)in group A were significantly longer than group B,and group C,P<0.05.The INR value was significantly higher than that in group B and group C,p<0.05.The levels of D-Di(ug/m L)and FDP(ug/m L)were significantly higher than group B and group C,P<0.05.FIB(g/L)level was significantly lower than that of group Band group C,P<0.05.APTT(s)in group C was significantly higher than that in group B,P<0.05.There was no significant difference in other coagulation indexes between group B and group C(P>0.05).Part 3: the R value after administration in group A was significantly higher than that in group B and group C,P<0.05.K value is significantly greater than group B and group C,P < 0.05).The Angle value was significantly lower than that of group B and group C,P<0.05.TEG showed no difference between group B and group C(P>0.05).ConclusionsTXA and hemagglutinin can significantly reduce the amount of blood loss during partial hepatectomy of hydatid hepatica in high altitude areas,and the amount of red blood cells suspension and fresh frozen plasma during operation can improve the coagulation function and fibrinolytic function after partial hepatectomy of hydatid hepatica.