Local application of tranexamic acid combined with hemostatic gauze in posterior surgery for thoracolumbar fractures

XIONG Wei; ZHOU Qi-bing; LIU Yi-feng

doi:10.11659/jjssx.04E025121

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Local application of tranexamic acid combined with hemostatic gauze in posterior surgery for thoracolumbar fractures

Clinical Research | 更新时间：2026-03-09

- Local application of tranexamic acid combined with hemostatic gauze in posterior surgery for thoracolumbar fractures
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 2, Pages: 161-164(2026)
- 作者机构：
  
  1.湖南省第二人民医院/湖南省脑科医院急诊外科，湖南长沙 410007
  2.湖南省第二人民医院/湖南省脑科医院脊柱外科，湖南长沙 410007
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.04E025121
  CLC： R683.2
- Received：25 May 2025，
  
  Published：25 February 2026
- 稿件说明：
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熊伟,周启兵,刘益锋.氨甲环酸联合止血纱在胸腰椎骨折后路手术中的局部应用[J].局解手术学杂志,2026,35(02):161-164.

XIONG Wei,ZHOU Qi-bing,LIU Yi-feng.Local application of tranexamic acid combined with hemostatic gauze in posterior surgery for thoracolumbar fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):161-164.
熊伟,周启兵,刘益锋.氨甲环酸联合止血纱在胸腰椎骨折后路手术中的局部应用[J].局解手术学杂志,2026,35(02):161-164. DOI： 10.11659/jjssx.04E025121.

XIONG Wei,ZHOU Qi-bing,LIU Yi-feng.Local application of tranexamic acid combined with hemostatic gauze in posterior surgery for thoracolumbar fractures[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):161-164. DOI： 10.11659/jjssx.04E025121.

摘要

目的

探讨氨甲环酸（TXA）联合止血纱在胸腰椎骨折后路手术中局部应用中的疗效及安全性。

方法

选取2022年6月至2024年12月在湖南省第二人民医院接受胸腰椎骨折后路手术的80例患者，随机分为观察组和对照组，每组40例。观察组患者采用TXA注射液浸渍止血纱后局部应用，对照组患者予以等量生理盐水浸渍止血纱后局部应用。观察2组患者术中失血量，术后8 h、24 h引流量及总引流量，拔管时间，术前及术后24 h、72 h的血红蛋白（Hb）、血细胞比容（Hct）、血小板计数（PLT）、D-二聚体（D-D）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT），术后视觉模拟量表（VAS）评分，以及术后并发症情况。

结果

2组患者术中失血量比较，差异无统计学意义（

=-0.13，

0.05）；观察组患者术后8 h、24 h引流量及总引流量均显著低于对照组（

0.01），术后拔管时间显著早于对照组（

0.01）。观察组患者术后24 h、72 h的Hb、Hct、PLT水平均显著高于对照组（

0.01）。2组患者各时间点的D-D、PT、APTT比较，差异均无统计学意义（

0.05）。观察组患者术后3 d、7 d的VAS评分显著低于对照组（

0.01）。对照组术后出现1例下肢深静脉血栓，观察组患者未出现相关并发症。

结论

TXA联合止血纱在胸腰椎骨折后路手术中局部应用可减少术后失血量，减轻术后疼痛，且不增加伤口感染、下肢血栓形成、脊髓马尾神经受压及中枢神经元损伤等并发症发生风险，安全性较高。

Abstract

Objective

To explore the efficacy and safety of local application of tranexamic acid （TXA） combined with hemostatic gauze in posterior surgery for thoracolumbar fractures.

Methods

A total of 80 patients who underwent posterior surgery for thoracolumbar fractures at the Second People's Hospital of Hunan Province from June 2022 to December 2024 were randomly divided into the observation group and the control group， with 40 patients in each group. Patients in the observation group were treated with TXA injection impregnated with hemostatic gauze for local application， while patients in the control group were treated with the same amount of normal saline impregnated with hemostatic gauze for local application. The intraoperative blood loss，drainage volume at 8 hours and 24 hours after surgery and total drainage volume，extubation time，hemoglobin （Hb），hematocrit （Hct），platelet （PLT），D-dimer （D-D），prothrombin time （PT），activated partial thromboplastin time （APTT） before surgery and 24 hours and 72 hours after surgery， postoperative visual analogue scale （VAS） score， and postoperative complications of patients in the two groups were observed and compared.

Results

There was no statistically significant difference in intraoperative blood loss of patients between the two groups （

=-0.13，

0.05）.The drainage volume at 24 hours and 72 hours after surgery and total drainage volume of patients in the observation group were significantly lower than those in the control group （

0.01）， and the postoperative extubation time was significantly earlier than that in the control group （

0.01）. The levels of Hb， Hct， and PLT at 24 hours and 72 hours after surgery of patients in the observation group were significantly higher than those in the control group （

0.01）. There were no statistically significant differences in D-D， PT， and APTT levels between the two groups at any time points （

0.05）. The VAS scores 3 days and 7 days after surgery of patients in the observation group were significantly lower than those in the control group （

0.01）. One case of deep vein thrombosis of the lower extremity occurred in the control group after surgery， while no related complications occurred in the observation group.

Conclusion

The local application of TXA combined with hemostatic gauze in posterior surgery for thoracolumbar fractures can reduce postoperative blood loss， alleviate postoperative pain，and does not increase the risks of wound infection，lower limb thrombosis，spinal cord and cauda equina nerve compression，and central neuronal injury， with high safety.

关键词

Keywords

references

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