The effects of antifibrinolytic drug use in decreasing hemoglobin drop following Percutaneous Nephrolithotomy in Al-Hillah Province

Dr. Adel Ibraheem Al-Najjar, A. Shubbar, Dheyaa Ali Hussein
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引用次数: 1

Abstract

Introduction: Objective: To assess the effectiveness and safety of tranexamic acid in lowering postoperative haemoglobin and hematocrit decline, operational time, postoperative complications, and hospitalisation in percutaneous nephrolithotomy patients. Methods: A 40-patient Al-Hilla Teaching Hospital randomised controlled clinical trial ran from January 2020 through July 2022. All ultrasound-guided PCNL patients with renal stones were randomised into two groups. Group A consisted of 20 patients (13 males and 7 females) with a mean age of (45.05 ±12.23) years who received tranexamic acid (1gm slow intravenous infusion diluted in 100 cc normal saline over 10 minutes) on call to surgery and then (0.5 gm infusion every 8 hours for the first 24 hours postoperatively). Group B included 20 non-tranexamic acid-treated patients (9 males and 11 females) with a mean age of 42.15 ± 10.64 years. We are comparing haemoglobin and hematocrit decline, operational time, postoperative complications, and hospitalisation between two groups. Results: Group A had a much lower postoperative haemoglobin decline than group B, 12.97 ±1.21 g/dl vs 11.82 ±1.44 (p = 0.010). Group A had a much lower postoperative hematocrit decline (39.11 ±3.95%) than group B (34.86 ±3.73%) (p = 0.001). 63.25 ±10.79 minutes against 73.50 ±16.31 minutes (p = 0.024). Group A had a significantly shorter hospital stay than group B (54.00 ±10.66 hours vs. 60.60 ±11.74 hours, p = 0.021). All patients in two groups had postoperative moderate hematuria, however group B had 4 (20.0%) instances of severe hematuria, whereas group A had just one (5%) case (p = 0.047). Four (20.0%) group B patients and one (5%) group A case required blood transfusion, a statistically significant difference (p = 0.047). Conclusions: TXA reduces postoperative haemoglobin and hematocrit drops and blood transfusions in PCNL with minimal side effects and a shorter operational time and hospital stay.
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使用抗纤溶药物降低Al-Hillah省经皮肾镜取石术后血红蛋白下降的效果
目的:评价氨甲环酸在降低经皮肾镜取石术患者术后血红蛋白和红细胞压积下降、手术时间、术后并发症和住院率方面的有效性和安全性。方法:从2020年1月到2022年7月,在Al-Hilla教学医院进行了一项40名患者的随机对照临床试验。所有超声引导下合并肾结石的PCNL患者随机分为两组。A组患者20例(男13例,女7例),平均年龄(45.05±12.23)岁,随叫随到接受氨甲环酸治疗(1gm慢速静脉滴注100cc生理盐水,10分钟内稀释),术后24小时每8小时滴注0.5 gm。B组20例未经氨甲环酸治疗的患者(男9例,女11例),平均年龄42.15±10.64岁。我们比较两组之间的血红蛋白和红细胞压积下降、手术时间、术后并发症和住院情况。结果:A组术后血红蛋白下降率明显低于B组,分别为12.97±1.21 g/dl和11.82±1.44 g/dl (p = 0.010)。A组术后红细胞压积下降(39.11±3.95%)明显低于B组(34.86±3.73%)(p = 0.001)。63.25±10.79 vs 73.50±16.31 (p = 0.024)。A组患者住院时间明显短于B组(54.00±10.66 h∶60.60±11.74 h, p = 0.021)。两组患者术后均有中度血尿,但B组有4例(20.0%)严重血尿,而A组只有1例(5%)(p = 0.047)。B组患者输血4例(20.0%),A组1例(5%),差异有统计学意义(p = 0.047)。结论:TXA降低了PCNL患者的术后血红蛋白和红细胞压积下降,减少了输血,副作用最小,缩短了手术时间和住院时间。
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