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首页> 外文期刊>BMC research notes >Tranexamic acid and the reduction of blood loss in total knee and hip arthroplasty: a meta-analysis
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Tranexamic acid and the reduction of blood loss in total knee and hip arthroplasty: a meta-analysis

机译：氨甲环酸和减少全膝和髋关节置换术中的失血：一项荟萃分析

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Background Tranexamic acid (TXA) is an antifibrinolytic drug used as a blood-sparing technique in many surgical specialties. The principal objective of our meta-analysis was to review randomized, controlled trials (RCT) comparing total blood loss and the number of patients receiving allogeneic blood transfusions with and without the use of TXA for knee (TKA) and hip (THA) arthroplasty. Methods Studies were included if patients underwent primary unilateral TKA or THA; the study involved the comparison of a TXA treatment group to a control group who received either a placebo or no treatment at all; outcome measures included total blood loss TBL, number of patients receiving allogeneic blood transfusions, and/or incidence of thromboembolic complications; the study was a published or unpublished RCT from 1995 – July 2012. Results Data were tested for publication bias and statistical heterogeneity. Combined weighted mean differences in blood loss favoured TXA over control for TKA and THA patients respectively [ ?1.149 ( p p 0.001; 95% CI, -0.672, -0.336)]. Combined odds ratios favoured fewer patients requiring allogeneic transfusions for TKA and THA with the use of TXA respectively [0.145 ( p 0.001; 95% CI, 0.094, 0.223), 0.327 ( p 0.001; 95% CI, 0.208, 0.515)]. Combined odds ratios indicated no increased incidence of DVT with TXA use in TKA and THA respectively [1.030 ( p = 0.946; 95% CI, 0.439, 2.420), 1.070 ( p = 0.895 ; 95% CI, 0.393, 2.911)]. Conclusions TXA should be considered for routine use in primary knee and hip arthroplasty to decrease blood loss.
机译：背景技术氨甲环酸（TXA）是一种抗纤溶药物，在许多外科专业领域中都用作降血药技术。我们的荟萃分析的主要目的是回顾随机对照试验（RCT），比较总失血量和接受和不接受TXA膝关节（TKA）和髋关节（THA）置换术的同种异体输血患者的数量。方法包括是否进行原发性单侧TKA或THA的研究;该研究包括将TXA治疗组与接受安慰剂或完全不接受治疗的对照组进行比较。结果指标包括总失血量TBL，接受异体输血的患者人数和/或血栓栓塞并发症的发生率;该研究是1995年至2012年7月间已发表或未发表的RCT。结果对数据的发表偏倚和统计异质性进行了测试。合并的失血加权平均差值分别使TKA和THA患者的TXA优于对照[？1.149（p p 0.001; 95％CI，-0.672，-0.336）]。综合比值比有利于较少的需要分别使用TXA进行TKA和THA同种异体输血的患者[0.145（p 0.001; 95％CI，0.094，0.223），0.327（p 0.001; 95％CI，0.208，0.515）]。综合比值比表明，在TKA和THA中DTX和TXA的使用分别不会增加DVT的发生率[1.030（p = 0.946; 95％CI，0.439，2.420），1.070（p = 0.895; 95％CI，0.393，2.911）。结论TXA在常规膝关节和髋关节置换术中应考虑常规使用，以减少失血。

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