关键词: 腰椎后路融合, 术后失血, 氨甲环酸, 退行性腰椎管狭窄

Abstract: Objective To investigate the effect and safety of local medication of tranexamic acid into wounds on reducing postoperation blood loss in posterior lumbar fusion for degenerative lumbar stenosis. Methods A retrospective study from January 2015 to February 2017 were performed for 81 patients with degenerative lumbar stenosis who first underwent posterior lumbar fusion surgery of one or two segments. The patients were divided into tranexamic acid group （group A, n=39） and control group （group B, n=42）according to whether using tranexamic acid, The operation of pedicle screw fixation, posterior laminectomy, bone plantation and lumbar interbody fusion were performed for all patients, the patients of group A were injected tranexamic acid（100 ml）into incision locally at the end of operation, while the group B did not receive that drug, then the drainage pipe will be clamped for 2 hours. Volume of the first 24 h and general drainage postoperative was compared and observed the morbidity of pulmonary embolism and deep vein thrombosis. Results It showed no statistically significant difference in age, gender, count of fusional segments, preoperative hematological result, duration of operation and intraoperative blood loss between the two groups（P>0.05）, both volume of the first 24 h drainage and general drainage of group A was significantly lower than that in the group B （P<0.05）. The pulmonary embolism and deep vein thrombosis were not found in the two groups. Conclusion The local medication of tranexamic acid at the end of posterior lumbar surgery, could reduce the postoperative blood loss significantly and not increase the risk of pulmonary embolism or deep vein thrombosis.

Key words: tranexamic acid , posterior lumbar fusion, degenerative lumbar stenosis , postoperative blood lose