Analysis of therapeutic effect of local application of thrombin lyophilized powder in the eradication of spinal tuberculosis focus

doi:10.3969/j.issn.1000-6621.2021.05.005

Abstract

Abstract:

Objective To explore the therapeutic effect of local application of thrombin lyophilized powder in the eradication of spinal tuberculosis focus. Methods A total of 106 spinal tuberculosis patients treated with parallel eradication of posterior spinal tuberculosis and internal fixation of bone graft between January 2020 and September 2020 from Beijing Chest Hospital Affiliated to Capital Medical University were retrospectively analyzed. They were divided into 2 groups according to the local use of thrombin during operation. The observation group (n=52) was treated with local use of thrombin for hemostasis, and the control group (n=54) was not treated with local use of thrombin. The intraoperative blood loss, 24 h postoperative blood loss, total postoperative flow, the maximum hemoglobin decrease, the percentage of hematocrit (HCT) one week after operation, the rate of blood transfusion, the occurrence of perioperative complications (thrombosis, incision nonunion, incision infection, subcutaneous hemorrhage, urinary tract infections, pulmonary infection, etc.), and the time of drainage tube removal of the two groups were compared. Results The postoperative flow 24 h postoperative, the total postoperative flow, the remove time of drainage tube, the HCT after the operation, the maximum hemoglobin decrease after the operation of observed group were significantly lower than those of the control group ((182.8±54.6) ml vs. (358.4±45.1) ml, t=2.732, P=0.009; (450.4±119.2) ml vs. (646.3±87.9) ml, t=2.264, P=0.037; (5.5±1.5) d vs. (7.2±2.1) d, t=2.132, P=0.048; (30.4±5.6) % vs. (27.2±7.3) %, t=2.238, P=0.049; (35.8±12.5) g/L vs. (48.3±17.9) g/L, t=2.056,P=0.043; respectively). The postoperative transfusion rates were 19.2% (10/52) and 27.8% (15/54) respectively in the two groups, and the difference was not significant. Conclusion Thrombin lyophilized powder can further reduce the total blood loss, the blood loss and the decreased value of hemoglobin within 24 h after the surgery of spinal tuberculosis, without increasement of the risk of postoperative complications, and can effectively promote the recovery.

Key words: Tuberculosis,spinal, Surgical procedures, operative, Thrombin lyophilized powder, Comparative effectiveness research

FAN Jun, DONG Wei-jie, LAN Ting-long, TANG Kai, LI Yuan, YAN Guang-xuan, WANG Heng, QIN Shi-bing. Analysis of therapeutic effect of local application of thrombin lyophilized powder in the eradication of spinal tuberculosis focus[J]. Chinese Journal of Antituberculosis, 2021, 43(5): 437-440. doi: 10.3969/j.issn.1000-6621.2021.05.005

Figures/Tables 2

组别	例数	性别 [例,构成比(%)]		年龄 (岁, $x ˉ$ ±s)	手术部位 [例,构成比(%)]		体质量指数 ( $x ˉ$ ±s)	术前血色素 (g/L, $x ˉ$ ±s)	术前红细胞比容 (%, $x ˉ$ ±s)	手术时间 (min, $x ˉ$ ±s)	术中出血量 (ml, $x ˉ$ ±s)
组别	例数	男	女	年龄 (岁, $x ˉ$ ±s)	胸椎	腰椎	体质量指数 ( $x ˉ$ ±s)	术前血色素 (g/L, $x ˉ$ ±s)	术前红细胞比容 (%, $x ˉ$ ±s)	手术时间 (min, $x ˉ$ ±s)	术中出血量 (ml, $x ˉ$ ±s)
观察组	52	34(65.4)	18(34.6)	46.4±13.3	28(53.8)	24(46.2)	19.3±2.1	129.6±22.3	38.5±8.2	192.5±25.6	257.6±23.7
对照组	54	33(61.1)	21(38.9)	47.2±14.4	25(46.3)	29(53.7)	20.7±1.8	131.1±18.7	40.2±7.6	190.9±30.7	269.3±33.7
统计检验值		χ²=0.208		t=0.622	χ²=0.604		t=0.610	t=0.673	t=0.656	t=0.634	t=0.692
P值		0.648		0.432	0.437		0.492	0.418	0.501	0.428	0.448

组别	例数	术后24h 引流量 (ml, $x ˉ$ ±s)	术后总引流量 (ml, $x ˉ$ ±s)	拔除引流管的时间 (d, $x ˉ$ ±s)	术后1周红细胞比容 (%, $x ˉ$ ±s)	最大血红蛋白下降值 (g/L, $x ˉ$ ±s)	输血 [例,比率(%)]
观察组	52	182.8±54.6	450.4±119.2	5.5±1.5	30.4±5.6	35.8±12.5	10(19.2)
对照组	54	358.4±45.1	646.3±87.9	7.2±2.1	27.2±7.3	48.3±17.9	15(27.8)
统计检验值		t=2.732	t=2.264	t=2.132	t=2.238	t=2.056	χ²=1.074
P值		0.009	0.037	0.048	0.049	0.043	0.300

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