中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Trauma
2015年
10期
907-912
,共6页
赵志虎%孙晓雷%马剑雄%李风波%李艳军%孟新民%吕建伟%马信龙
趙誌虎%孫曉雷%馬劍雄%李風波%李豔軍%孟新民%呂建偉%馬信龍
조지호%손효뢰%마검웅%리풍파%리염군%맹신민%려건위%마신룡
氨甲环酸%关节成形术,置换,膝%Meta分析
氨甲環痠%關節成形術,置換,膝%Meta分析
안갑배산%관절성형술,치환,슬%Meta분석
Tranexamic acid%Arthroplasty,replacement,knee%Meta analysis
目的 通过Meta分析评价局部应用和静脉注射氨甲环酸(TXA)对减少全膝关节置换(TKA)术后出血的有效性及安全性. 方法 计算机检索Cochrane Library、Embase、Pubmed英文数据库以及中国生物医学文献数据库、维普中国科技期刊数据库、万方数据库及中国知网数据库并手动检索会议论文及相关综述的参考文献中所有关于局部应用和静脉注射TXA治疗TKA术后出血的临床随机对照试验(RCTs),根据Jadad评分量表对纳入的文献进行评分,使用Revman 5.3软件进行Meta分析. 结果 共纳入8篇文献,纳入患者857例,其中局部应用TXA 396例,静脉注射TXA 461例.局部应用与静脉注射TXA在术后引流量(WMD=-17.25,95％ CI-202.64～168.15,P＞0.05)、失血量(WMD=14.30,95％ CI-98.82～127.42,P＞0.05)及血红蛋白下降值(WMD=-0.49,95％ CI-1.12 ～0.13,P＞0.05)、术后输血率(RD=-0.01,95％ CI-0.05 ～0.03,P＞0.05)及血栓事件的发生(RD =0.00,95％CI-0.02 ～ 0.02,P＞0.05)方面差异均无统计学意义. 结论 局部应用与静脉注射TXA在治疗TKA的有效性和安全性并无差异,两种给药方式均可以减少TKA术后出血而不增加其血栓形成的风险.
目的 通過Meta分析評價跼部應用和靜脈註射氨甲環痠(TXA)對減少全膝關節置換(TKA)術後齣血的有效性及安全性. 方法 計算機檢索Cochrane Library、Embase、Pubmed英文數據庫以及中國生物醫學文獻數據庫、維普中國科技期刊數據庫、萬方數據庫及中國知網數據庫併手動檢索會議論文及相關綜述的參攷文獻中所有關于跼部應用和靜脈註射TXA治療TKA術後齣血的臨床隨機對照試驗(RCTs),根據Jadad評分量錶對納入的文獻進行評分,使用Revman 5.3軟件進行Meta分析. 結果 共納入8篇文獻,納入患者857例,其中跼部應用TXA 396例,靜脈註射TXA 461例.跼部應用與靜脈註射TXA在術後引流量(WMD=-17.25,95％ CI-202.64～168.15,P＞0.05)、失血量(WMD=14.30,95％ CI-98.82～127.42,P＞0.05)及血紅蛋白下降值(WMD=-0.49,95％ CI-1.12 ～0.13,P＞0.05)、術後輸血率(RD=-0.01,95％ CI-0.05 ～0.03,P＞0.05)及血栓事件的髮生(RD =0.00,95％CI-0.02 ～ 0.02,P＞0.05)方麵差異均無統計學意義. 結論 跼部應用與靜脈註射TXA在治療TKA的有效性和安全性併無差異,兩種給藥方式均可以減少TKA術後齣血而不增加其血栓形成的風險.
목적 통과Meta분석평개국부응용화정맥주사안갑배산(TXA)대감소전슬관절치환(TKA)술후출혈적유효성급안전성. 방법 계산궤검색Cochrane Library、Embase、Pubmed영문수거고이급중국생물의학문헌수거고、유보중국과기기간수거고、만방수거고급중국지망수거고병수동검색회의논문급상관종술적삼고문헌중소유관우국부응용화정맥주사TXA치료TKA술후출혈적림상수궤대조시험(RCTs),근거Jadad평분량표대납입적문헌진행평분,사용Revman 5.3연건진행Meta분석. 결과 공납입8편문헌,납입환자857례,기중국부응용TXA 396례,정맥주사TXA 461례.국부응용여정맥주사TXA재술후인류량(WMD=-17.25,95％ CI-202.64～168.15,P＞0.05)、실혈량(WMD=14.30,95％ CI-98.82～127.42,P＞0.05)급혈홍단백하강치(WMD=-0.49,95％ CI-1.12 ～0.13,P＞0.05)、술후수혈솔(RD=-0.01,95％ CI-0.05 ～0.03,P＞0.05)급혈전사건적발생(RD =0.00,95％CI-0.02 ～ 0.02,P＞0.05)방면차이균무통계학의의. 결론 국부응용여정맥주사TXA재치료TKA적유효성화안전성병무차이,량충급약방식균가이감소TKA술후출혈이불증가기혈전형성적풍험.
Objective To evaluate the efficacy and safety of topical versus intravenous tranexamic acid (TXA) to reduce blood loss in primary total knee arthroplasty(TKA) through a Metaanalysis.Methods All randomized controlled trials (RCTs) comparing about the efficacy and safety of topical versus intravenous TXA to reduce postoperative blood loss during primary TKA were searched from Cochrane Library, Embase, PubMed, CBM, VIP, Wanfang data and CNKI.In the meantime, meeting and review studies were identified through hand searching.A quality assessment of the included literatures was tested using the Jadad scale.Software Revman 5.3 was used for the Meta-analysis.Results Eight RCTs involving 857 patients were identified including topical (396 cases) and venous (461 cases) application of TXA.The two groups were comparable pertaining to drainage volume (WMD =-17.25, 95％ CI-202.64-168.15 ,P ＞ 0.05), total blood loss (WMD =14.30, 95％ CI-98.82-127.42, P ＞ 0.05), drop-out value of hemoglobin (WMD =-0.49, 95 ％ CI-1.12-0.13, P ＞ 0.05), transfusion rate (RD =-0.01, 95％ CI-0.05-0.03 ,P ＞ 0.05) and embolism events (RD =0.00, 95％ CI-0.02-0.02, P ＞0.05).Conclusions Efficacy and safety of topical versus intravenous TXA have no significant differences.Either topical or intravenous therapy can be used to decrease the blood loss without increased risks of deep venous thrombosis or pulmonary embolism.
