To Analyze The Clinical Effect Of Tranexamic Acid In Single-level Posterior Lumbar Interbody Fusion

Objective:Retrospective analysis of the hemostatic effect and safety of preoperative single dose of intravenous tranexamic acid(TXA)in single-level posterior lumbar interbody fusion(PLIF).Methods:A total of 50 patients who underwent single-level PLIF in the Department of Orthopedic Oncology,Spine Surgery,Baise People’s Hospital from October 2020 to October2022 were selected.According to whether a single dose of intravenous TXA was used before surgery,the patients were divided into TXA group(25 cases)and control group(25 cases).There were 9 males and 16 females in the TXA group,aged 45-75 years.There were 13 males and 12 females in the control group,aged 36-74 years.The patients in the TXA group were given 1g TXA(1g TXA dissolved in 100 m L of 0.9% sodium chloride injection)30 minutes before surgery,and those in the control group were given 100 ml of 0.The general data,total blood loss,intraoperative blood loss,drainage volume within 24 hours after operation,drainage tube indwelling time,postoperative hospital stay,red blood cells(RBC),hemoglobin(HGB),hematocrit(hematocrit)before operation and on the first day after operation were recorded.HCT),platelet(PLT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),platelet(PLT),alanine aminotransferase(Alt),and aspartate aminotransferase(AST).AST),aystatin C(Cys C),creatinine(Cr),prothrombin time(prothrombin time,PT),activated paetial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB).Results:There was no significant difference in gender,age and body mass index between the two groups(P>0.05).The intraoperative blood loss was(502±236.17)ml in the TXA group and(838±181.02)ml in the control group(P<0.05).The total blood loss was 784.57±339.93 ml in the TXA group and 1094.88 ± 311.14 ml in the control group(P<0.05).The indwelling time of drainage tube was(43.5±4.37)h in the TXA group and(57.66±11.97)h in the control group,P<0.05,and the difference was statistically significant.The volume of drainage in 24 hours after operation was(152.4±61.66)ml in the TXA group and(152.2±38.35)ml in the control group(P>0.05).There were no significant differences in RBC,HGB,HCT,PLT,ALS,AST,APTT,PT,TT,FIB,Cr,Cys C and postoperative hospital stay between the two groups(P>0.05).There were no adverse events such as incision infection,fat liquefaction,cerebrospinal fluid leakage,and other adverse reactions such as headache,nausea,vomiting,and serious complications such as epilepsy,myocardial infarction,DVT,and PE in the two groups.Conclusion:(1)Preoperative single dose of intravenous tranexamic acid in single level posterior lumbar interbody fusion can reduce intraoperative blood loss,total blood loss,shorten the drainage tube indwelling time;(2)Preoperative single dose of intravenous tranexamic acid in single level posterior lumbar interbody fusion can not shorten the postoperative hospital stay and reduce postoperative drainage volume within 24 hours;(3)Preoperative single dose of intravenous tranexamic acid in single-level posterior lumbar interbody fusion does not affect the coagulation function,liver and kidney function after operation.