Effects of Tranexamic Acid on Blood Loss, Blood Transfusion, and Complications in Patients with Acute Stanford A Type Aortic Dissection Treated By Sun's Procedure
Department of Cardiothoracic Surgery, the First Hospital of Yulin City, Yulin, Shaanxi 719000, China
Abstract：【Objective】To explore the effects of tranexamic acid on blood loss, blood transfusion, and complications in patients with acute Stanford A type aortic dissection treated by Sun's procedure. 【Methods】Sixtytwo cases (including 8 off cases) of patients with acute Stanford A type aortic dissection who were admitted from September 2012 to September 2014 were selected as the study subjects. All patients underwent Sun's procedure. By the random number table method, the patients were divided into the control group (31 cases, 26 cases completed, 5 off cases) and the observation group (31 cases, 28 cases completed, 3 off cases). The observation group was treated with an intravenous injection of tranexamic acid (10 mg/kg) before the skin incision, and 30 min later the injection was completed. Then, an intravenous infusion of 10 mg/(kg•h) was performed until the end of surgery. The control group was given normal saline according to the same procedure as tranexamic acid was given to the observation group. Many intraoperative and postoperative indicator levels were observed between the two groups such as: total drainage volume 24h after surgery, homologous blood transfusion, hemostasis rate of a second open surgery, incidence of complications, and fatality rate 30 days after surgery. The interleukin6 (IL6), tumor necrosis factor alpha (TNFα), hemoglobin (Hb), and platelet count (PLT) were detected as well. 【Results】The mechanical ventilation time, length of ICU stay, and hospitalization time of the observation group was significantly shorter than those of the control group, and the total drainage volume in 24h postoperative and homologous blood transfusion was significantly less than that of the control group (P<0.05). There were no significant differences between the two groups in Hb and PLT after surgery and 24h after surgery (P>0.05). The hemostasis rate of the second open surgery in observation group (0) was significantly lower than that in the control group (15.38%) (P<0.05). The incidence rates of postoperative pulmonary infection, acute lung injury, and neurological dysfunction in the observation group (3.57%, 14.29%, 17.86%) were significantly lower than those in the control group (23.08%, 38.46%, 46.15%) (P<0.05). 【Conclusion】The application of tranexamic acid in acute Stanford A type aortic dissection can protect blood as well as reduce the incidence of postoperative complications.
2016, Vol. 33 
