Effects of tranexamic acid on intraoperative blood transfusion and postoperative thromboelastogram parameters in patients with partial hepatic resection of hydatid hepatica at high altitude / 中国输血杂志

ABSTRACT

【Objective】 To investigate the effects of tranexamic acid(TXA) on intraoperative blood transfusion(volume) and postoperative coagulation function in patients with partial hepatectomy for hepatic hydatid disease in high altitude area(altitude ≥2 500 m). 【Methods】 Forty-four patients [(39.09±14.70) years old, 19 males and 25 females] underwent elective partial hepatectomy for hydatid after general anesthesia from October 2018 to December 2019 in the Department of Hydatid of Qinghai Provincial People's Hospital, with ASA gradeⅠ~Ⅲ, Child Pugh grade A~B, and normal preoperative coagulation function. They were randomly divided into TXA injection group, who received intravenous injection of TXA 10 mg/(kg·person)(30 min before surgery), and control group, given a placebo needed the equal amounts of injected 0.9% sodium chloride(30 min before surgery). 3 mL of arterial blood was extracted from each patient before intravenous injection and at the end of operation for TEG detection. The intraoperative blood loss and transfusion volume as well as Plt, Hb and TEG parameters before and after surgery were compared between the two groups, and statistical analysis was performed with SPSS22.0 statistical software. 【Results】 The volume of intraoperative blood loss(mL) in TXA group and control group was 300(200, 1 000) vs 1 400(1 000, 2 100), respectively; the units of plasma transfusion(mL) 0(0, 0) vs 380(0, 575); the units of RBC suspension transfusion(mL) 0(0, 400) vs 1 200(800, 600). Preoperative TEG parameters of two groups were similar to each other(P>0.05). The postoperative R, K and Angle(°) of two groups was 8.32±2.24 vs 10.78±2.67, 2.80(2.10, 3.30) vs 3.70(3.20, 4.80) and 54.76±9.48 vs 43.70±9.02, respectively(P<0.05). 【Conclusion】 TXA can significantly improve coagulation functions, as well as effectively reduce intraoperative blood loss and intraoperative blood transfusion in patients with partial hepatic resection of hydatid hepatica in high altitude area.