Tranexamic acid reduces blood loss in percutaneous nephrolithotomy: A prospective randomized controlled study

摘要

Severe hemorrhage is one of the most feared complications of percutaneous nephrolithotomy (PNL) and is associated with complex stone configuration and stone burden. Appropriate access technique, including direct puncture end-on into a calyx, avoidance of infundibular puncture, and using the shortest tract traversing the least amount of parenchyma can help minimize bleeding. Nevertheless, it remains incontrovertible that PNL is accomplished through a controlled stab wound to the kidney, and often multiple stab wounds are required. In this paper, the authors examined the use of transexamic acid (TA), a safe and inexpensive drug which inhibits plas-min, to decrease bleeding in patients undergoing PNL. A total of 200 patients were randomized, with half receiving intravenous TA immediately before PNL followed by three oral doses over the next 24 hours and half not receiving any drug.