Progress on the application of tranexamic acid in adolescent spine corrective surgery_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Zhuang , YANG Xi , WANG Lei ,  SONG Yueming

Department of Orthopedic Surgery/Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

SONG Yueming, Email: prof_songyueming@163.com

Keywords：

Adolescent; spinal corrective surgery; tranexamic acid; intraoperative blood loss

DOI：

10.7507/1002-1892.202001052

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To review the advances in the application of tranexamic acid (TXA) in adolescent spinal corrective surgery.Methods The mechanism of action and pharmacokinetic, effectiveness, dosage, safety as well as methods of administration were comprehensively summarized by consulting domestic and overseas related literature about the application of TXA in adolescent spinal corrective surgery in recent years.Results TXA efficaciously reduce intraoperative blood loss, transfusion rate and volume, postoperative drainage volume in adolescent spinal corrective surgery. At present, the most common method of administration in adolescent spinal corrective surgery is that a loading dose is given intravenously before skin incision or induction of anesthesia, followed by a maintenance dose until the end of the surgery. The range of loading dose and maintenance dose is 10-100 mg/kg and 1-10 mg/(kg·h), respectively. No drug related adverse event has been reported in this range.Conclusion The effectiveness and safety of TXA in adolescent spinal surgery have been basically confirmed. However, further studies are needed to determine the optimal dosage, method of administration as well as whether it could reduce blood loss after surgery.

Citation： ZHANG Zhuang, YANG Xi, WANG Lei, SONG Yueming. Progress on the application of tranexamic acid in adolescent spine corrective surgery. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(11): 1468-1473. doi: 10.7507/1002-1892.202001052 Copy

1.	Weinstein SL, Dolan LA, Cheng JC, et al. Adolescent idiopathic scoliosis. Lancet, 2008, 371(9623): 1527-1537.
2.	Guay J, Haig M, Lortie L, et al. Predicting blood loss in surgery for idiopathic scoliosis. Can J Anaesth, 1994, 41(9): 775-781.
3.	Soviero F, Geraci A, Termine S, et al. Bleeding in orthopaedic surgery: the role of blood transfusion and erythropoietin alpha. Acta Biomed, 2010, 81(2): 125-129.
4.	Hiippala ST, Strid LJ, Wennerstrand MI, et al. Tranexamic acid radically decreases blood loss and transfusions associated with total knee arthroplasty. Anesth Analg, 1997, 84(4): 839-844.
5.	Ekbäck G, Axelsson K, Ryttberg L, et al. Tranexamic acid reduces blood loss in total hip replacement surgery. Anesth Analg, 2000, 91(5): 1124-1130.
6.	Neilipovitz DT, Murto K, Hall L, et al. A randomized trial of tranexamic acid to reduce blood transfusion for scoliosis surgery. Anesth Analg, 2001, 93(1): 82-87.
7.	McCormack PL. Tranexamic acid: a review of its use in the treatment of hyperfibrinolysis. Drugs, 2012, 72(5): 585-617.
8.	Hunt BJ. The current place of tranexamic acid in the management of bleeding. Anaesthesia, 2015, 70(Suppl 1): 50-53.
9.	Bosch P, Kenkre TS, Soliman D, et al. Comparison of the coagulation profile of adolescent idiopathic scoliosis patients undergoing posterior spinal fusion with and without tranexamic acid. Spine Deform, 2019, 7(6): 910-916.
10.	Pilbrant A, Schannong M, Vessman J. Pharmacokinetics and bioavailability of tranexamic acid. Eur J Clin Pharmacol, 1981, 20(1): 65-72.
11.	Eriksson O, Kjellman H, Pilbrant A, et al. Pharmacokinetics of tranexamic acid after intravenous administration to normal volunteers. Eur J Clin Pharmacol, 1974, 7(5): 375-380.
12.	Andersson L, Eriksson O, Hedlund PO, et al. Special considerations with regard to the dosage of tranexamic acid in patients with chronic renal diseases. Urol Res, 1978, 6(2): 83-88.
13.	Nilsson IM. Clinical pharmacology of aminocaproic and tranexamic acids. J Clin Pathol Suppl (R Coll Pathol), 1980, 14: 41-47.
14.	Goobie SM, Zurakowski D, Glotzbecker MP, et al. Tranexamic acid is efficacious at decreasing the rate of blood loss in adolescent scoliosis surgery: A randomized placebo-controlled trial. J Bone Joint Surg (Am), 2018, 100(23): 2024-2032.
15.	Sui WY, Ye F, Yang JL. Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery. BMC Musculoskelet Disord, 2016, 17: 187.
16.	Lykissas MG, Crawford AH, Chan G, et al. The effect of tranexamic acid in blood loss and transfusion volume in adolescent idiopathic scoliosis surgery: a single-surgeon experience. J Child Orthop, 2013, 7(3): 245-249.
17.	Shapiro F, Zurakowski D, Sethna NF. Tranexamic acid diminishes intraoperative blood loss and transfusion in spinal fusions for duchenne muscular dystrophy scoliosis. Spine (Phila Pa 1976), 2007, 32(20): 2278-2283.
18.	Yagi M, Hasegawa J, Nagoshi N, et al. Does the intraoperative tranexamic acid decrease operative blood loss during posterior spinal fusion for treatment of adolescent idiopathic scoliosis? Spine (Phila Pa 1976), 2012, 37(21): E1336-E1342.
19.	Ng BK, Chau WW, Hung AL, et al. Use of tranexamic acid (TXA) on reducing blood loss during scoliosis surgery in Chinese adolescents. Scoliosis, 2015, 10: 28.
20.	陈晖, 阚世廉. 氨甲环酸减少青少年特发性脊柱侧凸后路融合固定术失血的临床研究. 天津医药, 2015, 43(9): 1044-1046.
21.	张晓坤, 周路阳, 董媛媛, 等. 氨甲环酸对青少年特发性脊柱侧弯后路矫形术患者围术期出血的影响. 江苏医药, 2015, 41(6): 671-672.
22.	Newton PO, Bastrom TP, Emans JB, et al. Antifibrinolytic agents reduce blood loss during pediatric vertebral column resection procedures. Spine (Phila Pa 1976), 2012, 37(23): E1459-E1463.
23.	解京明, 李韬, 王迎松, 等. 大剂量氨甲环酸用于脊柱矫形手术的安全性和有效性. 中国脊柱脊髓杂志, 2016, 26(1): 48-54.
24.	Verma K, Errico T, Diefenbach C, et al. The relative efficacy of antifibrinolytics in adolescent idiopathic scoliosis: a prospective randomized trial. J Bone Joint Surg (Am), 2014, 96(10): e80.
25.	Xu C, Wu A, Yue Y. Which is more effective in adolescent idiopathic scoliosis surgery: batroxobin, tranexamic acid or a combination? Arch Orthop Trauma Surg, 2012, 132(1): 25-31.
26.	祁术元, 冷爱华, 梁文静, 等. 氨甲环酸在脊柱侧弯矫形术中血液保护的应用研究. 北京医学, 2018, 40(12): 1163-1166.
27.	Fiechtner BK, Nuttall GA, Johnson ME, et al. Plasma tranexamic acid concentrations during cardiopulmonary bypass. Anesth Analg, 2001, 92(5): 1131-1136.
28.	Yoo JS, Ahn J, Karmarkar SS, et al. The use of tranexamic acid in spine surgery. Ann Transl Med, 2019, 7(Suppl 5): S172.
29.	Garg B, Dhatt S, Chakraborty S, et al. Use of single-dose tranexamic acid to reduce blood loss in operative thoracolumbar trauma: a comparative study. Spine, 2012, 12(9): S93.
30.	Wang Q, Liu J, Fan R, et al. Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery: a randomized controlled trial. Eur Spine J, 2013, 22(9): 2035-2038.
31.	Carabini LM, Moreland NC, Vealey RJ, et al. A randomized controlled trial of low-dose tranexamic acid versus placebo to reduce red blood cell transfusion during complex multilevel spine Fusion Surgery. World Neurosurg, 2018, 110: e572-e579.
32.	Shakeri M, Salehpour F, Shokouhi G, et al. Minimal dose of tranexamic acid is effective in reducing blood loss in complex spine surgeries: a randomized double-blind placebo controlled study. Asian Spine J, 2018, 12(3): 484-489.
33.	Zhong J, Cao K, Wang B, et al. The perioperative efficacy and safety of tranexamic acid in adolescent idiopathic scoliosis. World Neurosurg, 2019, 129: e726-e732.
34.	Johnson DJ, Johnson CC, Goobie SM, et al. High-dose versus low-dose tranexamic acid to reduce transfusion requirements in pediatric scoliosis surgery. J Pediatr Orthop, 2017, 37(8): e552-e557.
35.	Grant JA, Howard J, Luntley J, et al. Perioperative blood transfusion requirements in pediatric scoliosis surgery: the efficacy of tranexamic acid. J Pediatr Orthop, 2009, 29(3): 300-304.
36.	Sethna NF, Zurakowski D, Brustowicz RM, et al. Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery. Anesthesiology, 2005, 102(4): 727-732.
37.	Yuan QM, Zhao ZH, Xu BS. Efficacy and safety of tranexamic acid in reducing blood loss in scoliosis surgery: a systematic review and meta-analysis. Eur Spine J, 2017, 26(1): 131-139.
38.	Alajmi T, Saeed H, Alfaryan K, et al. Efficacy of tranexamic acid in reducing blood loss and blood transfusion in idiopathic scoliosis: a systematic review and meta-analysis. J Spine Surg, 2017, 3(4): 531-540.
39.	Yu CC, Kadri O, Kadado A, et al. Intravenous and oral tranexamic acid are equivalent at reducing blood loss in thoracolumbar spinal fusion: a prospective randomized trial. Spine (Phila Pa 1976), 2019, 44(11): 755-761.
40.	张培楠, 杨新明, 贾永利, 等. 不同方式应用氨甲环酸对布氏杆菌性脊柱炎患者围手术期失血的影响. 实用医学杂志, 2018, 34(11): 1898-1901, 1906.
41.	郑菡, 彭霁, 任运钦, 等. 局部应用氨甲环酸对脊柱手术患者凝血及纤溶功能的影响. 解放军医学杂志, 2019, 44(5): 405-411.
42.	Liang JQ, Rong TH, Liu HZ, et al. Topical injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in degenerative lumbar scoliosis surgery. Orthop Surg, 2020, 12(1): 67-73.
43.	杨秀美, 王刚, 黄青青, 等. 氨甲环酸在椎体切除脊柱矫形术中的用药方式及安全性. 昆明医科大学学报, 2019, 40(5): 91-95.
44.	Xie J, Ma J, Yao H, et al. Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss after primary total knee arthroplasty without tourniquet: a randomized clinical trial. J Arthroplasty, 2016, 31(11): 2458-2464.
45.	Xie J, Hu Q, Ma J, et al. Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss and the inflammatory response following enhanced-recovery primary total hip arthroplasty: a randomised clinical trial. Bone Joint J, 2017, 99-B(11): 1442-1449.
46.	Wang D, Yang Y, He C, et al. Effect of multiple doses of oral Tranexamic acid on haemostasis and inflammatory reaction in total hip arthroplasty: a randomized controlled trial. Thromb Haemost, 2019, 119(1): 92-103.
47.	Wang D, Wang HY, Luo ZY, et al. Blood-conserving efficacy of multiple doses of oral tranexamic acid associated with an enhanced-recovery programme in primary total knee arthroplasty: a randomized controlled trial. Bone Joint J, 2018, 100-B(8): 1025-1032.
48.	Slattery C, Kark J, Wagner T, et al. The use of tranexamic acid to reduce surgical blood loss: a review basic science, subspecialty studies, and the evolution of use in spine deformity surgery. Clin Spine Surg, 2019, 32(2): 46-50.
49.	Mangano DT, Miao Y, Vuylsteke A, et al. Mortality associated with aprotinin during 5 years following coronary artery bypass graft surgery. JAMA, 2007, 297(5): 471-479.
50.	Calapai G, Gangemi S, Mannucci C, et al. Systematic review of tranexamic acid adverse reactions. Journal of Pharmacovigilance, 2015, 3(4). doi: 10.4172/2329-6887.1000171.
51.	Zhang Y, Liu H, He F, et al. Does tranexamic acid improve bleeding, transfusion, and hemoglobin level in patients undergoing multilevel spine surgery? A systematic review and meta-analysis. World Neurosurg, 2019, 127: 289-301.
52.	Cheriyan T, Maier SP 2nd, Bianco K, et al. Efficacy of tranexamic acid on surgical bleeding in spine surgery: a meta-analysis. Spine J, 2015, 15(4): 752-761.
53.	刘嘉明, 彭慧明, 沈建雄, 等. 脊柱手术中应用氨甲环酸的有效性和安全性荟萃分析. 中华外科杂志, 2010, 48(12): 937-942.
54.	黄智勇. 氨甲环酸药物用于脊柱手术有效性与安全性的 Meta 分析. 现代实用医学, 2017, 29(3): 357-359.
55.	Kalavrouziotis D, Voisine P, Mohammadi S, et al. High-dose tranexamic acid is an independent predictor of early seizure after cardiopulmonary bypass. Ann Thorac Surg, 2012, 93(1): 148-154.
56.	Upadhyay SP, Mallick PN, Jagia M, et al. Acute arterial thrombosis associated with inadvertent high dose of tranexamic acid. Indian J Crit Care Med, 2013, 17(4): 237-239.
57.	Berman M, Cardone D, Sharples L, et al. Safety and efficacy of aprotinin and tranexamic acid in pulmonary endarterectomy surgery with hypothermia: review of 200 patients. Ann Thorac Surg, 2010, 90(5): 1432-1436.
58.	郝茂林, 郝苗清, 杜怡峰. 氨甲环酸相关型癫痫的研究进展. 医学综述, 2017, 23(2): 332-335.
59.	Sharma V, Katznelson R, Jerath A, et al. The association between tranexamic acid and convulsive seizures after cardiac surgery: a multivariate analysis in 11 529 patients. Anaesthesia, 2014, 69(2): 124-130.
60.	顾力军, 张洪美, 张斌, 等. 脊柱手术发生氨甲环酸相关型癫痫 1 例. 中国骨伤, 2018, 31(3): 276-278.
61.	Manji RA, Grocott HP, Leake J, et al. Seizures following cardiac surgery: the impact of tranexamic acid and other risk factors. Can J Anaesth, 2012, 59(1): 6-13.
62.	Cravens GT, Brown MJ, Brown DR, et al. Antifibrinolytic therapy use to mitigate blood loss during staged complex major spine surgery: Postoperative visual color changes after tranexamic acid administration. Anesthesiology, 2006, 105(6): 1274-1276.

1. Weinstein SL, Dolan LA, Cheng JC, et al. Adolescent idiopathic scoliosis. Lancet, 2008, 371(9623): 1527-1537.
2. Guay J, Haig M, Lortie L, et al. Predicting blood loss in surgery for idiopathic scoliosis. Can J Anaesth, 1994, 41(9): 775-781.
3. Soviero F, Geraci A, Termine S, et al. Bleeding in orthopaedic surgery: the role of blood transfusion and erythropoietin alpha. Acta Biomed, 2010, 81(2): 125-129.
4. Hiippala ST, Strid LJ, Wennerstrand MI, et al. Tranexamic acid radically decreases blood loss and transfusions associated with total knee arthroplasty. Anesth Analg, 1997, 84(4): 839-844.
5. Ekbäck G, Axelsson K, Ryttberg L, et al. Tranexamic acid reduces blood loss in total hip replacement surgery. Anesth Analg, 2000, 91(5): 1124-1130.
6. Neilipovitz DT, Murto K, Hall L, et al. A randomized trial of tranexamic acid to reduce blood transfusion for scoliosis surgery. Anesth Analg, 2001, 93(1): 82-87.
7. McCormack PL. Tranexamic acid: a review of its use in the treatment of hyperfibrinolysis. Drugs, 2012, 72(5): 585-617.
8. Hunt BJ. The current place of tranexamic acid in the management of bleeding. Anaesthesia, 2015, 70(Suppl 1): 50-53.
9. Bosch P, Kenkre TS, Soliman D, et al. Comparison of the coagulation profile of adolescent idiopathic scoliosis patients undergoing posterior spinal fusion with and without tranexamic acid. Spine Deform, 2019, 7(6): 910-916.
10. Pilbrant A, Schannong M, Vessman J. Pharmacokinetics and bioavailability of tranexamic acid. Eur J Clin Pharmacol, 1981, 20(1): 65-72.
11. Eriksson O, Kjellman H, Pilbrant A, et al. Pharmacokinetics of tranexamic acid after intravenous administration to normal volunteers. Eur J Clin Pharmacol, 1974, 7(5): 375-380.
12. Andersson L, Eriksson O, Hedlund PO, et al. Special considerations with regard to the dosage of tranexamic acid in patients with chronic renal diseases. Urol Res, 1978, 6(2): 83-88.
13. Nilsson IM. Clinical pharmacology of aminocaproic and tranexamic acids. J Clin Pathol Suppl (R Coll Pathol), 1980, 14: 41-47.
14. Goobie SM, Zurakowski D, Glotzbecker MP, et al. Tranexamic acid is efficacious at decreasing the rate of blood loss in adolescent scoliosis surgery: A randomized placebo-controlled trial. J Bone Joint Surg (Am), 2018, 100(23): 2024-2032.
15. Sui WY, Ye F, Yang JL. Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery. BMC Musculoskelet Disord, 2016, 17: 187.
16. Lykissas MG, Crawford AH, Chan G, et al. The effect of tranexamic acid in blood loss and transfusion volume in adolescent idiopathic scoliosis surgery: a single-surgeon experience. J Child Orthop, 2013, 7(3): 245-249.
17. Shapiro F, Zurakowski D, Sethna NF. Tranexamic acid diminishes intraoperative blood loss and transfusion in spinal fusions for duchenne muscular dystrophy scoliosis. Spine (Phila Pa 1976), 2007, 32(20): 2278-2283.
18. Yagi M, Hasegawa J, Nagoshi N, et al. Does the intraoperative tranexamic acid decrease operative blood loss during posterior spinal fusion for treatment of adolescent idiopathic scoliosis? Spine (Phila Pa 1976), 2012, 37(21): E1336-E1342.
19. Ng BK, Chau WW, Hung AL, et al. Use of tranexamic acid (TXA) on reducing blood loss during scoliosis surgery in Chinese adolescents. Scoliosis, 2015, 10: 28.
20. 陈晖, 阚世廉. 氨甲环酸减少青少年特发性脊柱侧凸后路融合固定术失血的临床研究. 天津医药, 2015, 43(9): 1044-1046.
21. 张晓坤, 周路阳, 董媛媛, 等. 氨甲环酸对青少年特发性脊柱侧弯后路矫形术患者围术期出血的影响. 江苏医药, 2015, 41(6): 671-672.
22. Newton PO, Bastrom TP, Emans JB, et al. Antifibrinolytic agents reduce blood loss during pediatric vertebral column resection procedures. Spine (Phila Pa 1976), 2012, 37(23): E1459-E1463.
23. 解京明, 李韬, 王迎松, 等. 大剂量氨甲环酸用于脊柱矫形手术的安全性和有效性. 中国脊柱脊髓杂志, 2016, 26(1): 48-54.
24. Verma K, Errico T, Diefenbach C, et al. The relative efficacy of antifibrinolytics in adolescent idiopathic scoliosis: a prospective randomized trial. J Bone Joint Surg (Am), 2014, 96(10): e80.
25. Xu C, Wu A, Yue Y. Which is more effective in adolescent idiopathic scoliosis surgery: batroxobin, tranexamic acid or a combination? Arch Orthop Trauma Surg, 2012, 132(1): 25-31.
26. 祁术元, 冷爱华, 梁文静, 等. 氨甲环酸在脊柱侧弯矫形术中血液保护的应用研究. 北京医学, 2018, 40(12): 1163-1166.
27. Fiechtner BK, Nuttall GA, Johnson ME, et al. Plasma tranexamic acid concentrations during cardiopulmonary bypass. Anesth Analg, 2001, 92(5): 1131-1136.
28. Yoo JS, Ahn J, Karmarkar SS, et al. The use of tranexamic acid in spine surgery. Ann Transl Med, 2019, 7(Suppl 5): S172.
29. Garg B, Dhatt S, Chakraborty S, et al. Use of single-dose tranexamic acid to reduce blood loss in operative thoracolumbar trauma: a comparative study. Spine, 2012, 12(9): S93.
30. Wang Q, Liu J, Fan R, et al. Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery: a randomized controlled trial. Eur Spine J, 2013, 22(9): 2035-2038.
31. Carabini LM, Moreland NC, Vealey RJ, et al. A randomized controlled trial of low-dose tranexamic acid versus placebo to reduce red blood cell transfusion during complex multilevel spine Fusion Surgery. World Neurosurg, 2018, 110: e572-e579.
32. Shakeri M, Salehpour F, Shokouhi G, et al. Minimal dose of tranexamic acid is effective in reducing blood loss in complex spine surgeries: a randomized double-blind placebo controlled study. Asian Spine J, 2018, 12(3): 484-489.
33. Zhong J, Cao K, Wang B, et al. The perioperative efficacy and safety of tranexamic acid in adolescent idiopathic scoliosis. World Neurosurg, 2019, 129: e726-e732.
34. Johnson DJ, Johnson CC, Goobie SM, et al. High-dose versus low-dose tranexamic acid to reduce transfusion requirements in pediatric scoliosis surgery. J Pediatr Orthop, 2017, 37(8): e552-e557.
35. Grant JA, Howard J, Luntley J, et al. Perioperative blood transfusion requirements in pediatric scoliosis surgery: the efficacy of tranexamic acid. J Pediatr Orthop, 2009, 29(3): 300-304.
36. Sethna NF, Zurakowski D, Brustowicz RM, et al. Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery. Anesthesiology, 2005, 102(4): 727-732.
37. Yuan QM, Zhao ZH, Xu BS. Efficacy and safety of tranexamic acid in reducing blood loss in scoliosis surgery: a systematic review and meta-analysis. Eur Spine J, 2017, 26(1): 131-139.
38. Alajmi T, Saeed H, Alfaryan K, et al. Efficacy of tranexamic acid in reducing blood loss and blood transfusion in idiopathic scoliosis: a systematic review and meta-analysis. J Spine Surg, 2017, 3(4): 531-540.
39. Yu CC, Kadri O, Kadado A, et al. Intravenous and oral tranexamic acid are equivalent at reducing blood loss in thoracolumbar spinal fusion: a prospective randomized trial. Spine (Phila Pa 1976), 2019, 44(11): 755-761.
40. 张培楠, 杨新明, 贾永利, 等. 不同方式应用氨甲环酸对布氏杆菌性脊柱炎患者围手术期失血的影响. 实用医学杂志, 2018, 34(11): 1898-1901, 1906.
41. 郑菡, 彭霁, 任运钦, 等. 局部应用氨甲环酸对脊柱手术患者凝血及纤溶功能的影响. 解放军医学杂志, 2019, 44(5): 405-411.
42. Liang JQ, Rong TH, Liu HZ, et al. Topical injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in degenerative lumbar scoliosis surgery. Orthop Surg, 2020, 12(1): 67-73.
43. 杨秀美, 王刚, 黄青青, 等. 氨甲环酸在椎体切除脊柱矫形术中的用药方式及安全性. 昆明医科大学学报, 2019, 40(5): 91-95.
44. Xie J, Ma J, Yao H, et al. Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss after primary total knee arthroplasty without tourniquet: a randomized clinical trial. J Arthroplasty, 2016, 31(11): 2458-2464.
45. Xie J, Hu Q, Ma J, et al. Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss and the inflammatory response following enhanced-recovery primary total hip arthroplasty: a randomised clinical trial. Bone Joint J, 2017, 99-B(11): 1442-1449.
46. Wang D, Yang Y, He C, et al. Effect of multiple doses of oral Tranexamic acid on haemostasis and inflammatory reaction in total hip arthroplasty: a randomized controlled trial. Thromb Haemost, 2019, 119(1): 92-103.
47. Wang D, Wang HY, Luo ZY, et al. Blood-conserving efficacy of multiple doses of oral tranexamic acid associated with an enhanced-recovery programme in primary total knee arthroplasty: a randomized controlled trial. Bone Joint J, 2018, 100-B(8): 1025-1032.
48. Slattery C, Kark J, Wagner T, et al. The use of tranexamic acid to reduce surgical blood loss: a review basic science, subspecialty studies, and the evolution of use in spine deformity surgery. Clin Spine Surg, 2019, 32(2): 46-50.
49. Mangano DT, Miao Y, Vuylsteke A, et al. Mortality associated with aprotinin during 5 years following coronary artery bypass graft surgery. JAMA, 2007, 297(5): 471-479.
50. Calapai G, Gangemi S, Mannucci C, et al. Systematic review of tranexamic acid adverse reactions. Journal of Pharmacovigilance, 2015, 3(4). doi: 10.4172/2329-6887.1000171.
51. Zhang Y, Liu H, He F, et al. Does tranexamic acid improve bleeding, transfusion, and hemoglobin level in patients undergoing multilevel spine surgery? A systematic review and meta-analysis. World Neurosurg, 2019, 127: 289-301.
52. Cheriyan T, Maier SP 2nd, Bianco K, et al. Efficacy of tranexamic acid on surgical bleeding in spine surgery: a meta-analysis. Spine J, 2015, 15(4): 752-761.
53. 刘嘉明, 彭慧明, 沈建雄, 等. 脊柱手术中应用氨甲环酸的有效性和安全性荟萃分析. 中华外科杂志, 2010, 48(12): 937-942.
54. 黄智勇. 氨甲环酸药物用于脊柱手术有效性与安全性的 Meta 分析. 现代实用医学, 2017, 29(3): 357-359.
55. Kalavrouziotis D, Voisine P, Mohammadi S, et al. High-dose tranexamic acid is an independent predictor of early seizure after cardiopulmonary bypass. Ann Thorac Surg, 2012, 93(1): 148-154.
56. Upadhyay SP, Mallick PN, Jagia M, et al. Acute arterial thrombosis associated with inadvertent high dose of tranexamic acid. Indian J Crit Care Med, 2013, 17(4): 237-239.
57. Berman M, Cardone D, Sharples L, et al. Safety and efficacy of aprotinin and tranexamic acid in pulmonary endarterectomy surgery with hypothermia: review of 200 patients. Ann Thorac Surg, 2010, 90(5): 1432-1436.
58. 郝茂林, 郝苗清, 杜怡峰. 氨甲环酸相关型癫痫的研究进展. 医学综述, 2017, 23(2): 332-335.
59. Sharma V, Katznelson R, Jerath A, et al. The association between tranexamic acid and convulsive seizures after cardiac surgery: a multivariate analysis in 11 529 patients. Anaesthesia, 2014, 69(2): 124-130.
60. 顾力军, 张洪美, 张斌, 等. 脊柱手术发生氨甲环酸相关型癫痫 1 例. 中国骨伤, 2018, 31(3): 276-278.
61. Manji RA, Grocott HP, Leake J, et al. Seizures following cardiac surgery: the impact of tranexamic acid and other risk factors. Can J Anaesth, 2012, 59(1): 6-13.
62. Cravens GT, Brown MJ, Brown DR, et al. Antifibrinolytic therapy use to mitigate blood loss during staged complex major spine surgery: Postoperative visual color changes after tranexamic acid administration. Anesthesiology, 2006, 105(6): 1274-1276.

Previous Article
Progress on the evaluation method of paraspinal muscle and its correlation with lumbar diseases
Next Article
Research progress of ureteral injury in oblique lumbar interbody fusion

Chinese Journal of Reparative and Reconstructive Surgery

Progress on the application of tranexamic acid in adolescent spine corrective surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content