摘要
[目的]评价氨甲环酸对全膝关节置换术后失血量等指标的影响及其安全性。[方法]利用互联网检索数据库The Cochrane Library(2011年第4期)、Ovid(1948年～2011年12月)、PubMed(1966年～2011年12月)、EM-BASE(1966年～2011年12月)、中国期刊全文数据库(CNKI,1994年～2011年12月),检出氨甲环酸在全膝关节置换术中应用的相关文献,筛选出符合纳入标准的随机对照试验。提取数据,采用RevMan 5.0软件进行Meta分析,比较氨甲环酸组与对照组在失血量、输血率、术后并发症等方面的差异。[结果]共纳入随机对照研究15篇。Meta分析结果显示,使用氨甲环酸可以减少病人平均总失血量513.03 ml[95%置信区间(-678.26,-347.81),P<0.01]、平均术中出血量94.03 ml[95%置信区间(-297.97,91.92),P=0.32]、平均术后出血量297.22 ml[95%置信区间(-772.50,178.05),P=0.22];氨甲环酸可以显著降低输血率[危险度差值0.29,95%置信区间(-0.40,-0.17),P<0.01]、平均输血量0.99个单位[95%置信区间(-1.48,-0.49),P<0.01];两组间深静脉血栓、肺栓塞发生率的差异无统计学意义(P>0.1)。[结论]氨甲环酸能有效减少全膝关节置换术的失血量,降低输血率和输血量,且并未增加术后DVT及PE的发生率。
[ Objective ] To assess the effect and safety of tranexamic acid （TA） used in total knee arthroplasty （TKA） by making a systematic review and meta - analysis. [ Methods ] Literatures were retrieved from Cochrane Library （ CENTRAL, 2011 Issue 4）, Ovid （ 1948 to December 2011 ）, PubMed （ 1966 to December 2011 ）, EMBASE （ 1966 to December 2011 ） and CNKI （1994 to December 2011 ） . All the related literatures were checked by two independent reviewers and only the high quality randomized controlled trails （RCTs） were enrolled. The relevant data were analyzed using RevMan 5.0 to compare the difference of blood loss, transfusion and complications between TA group and placebo group. [ Results ] Only 15 high quality RCTs met the inclusion criteria. The use of TA in TKA significantly reduced total blood loss by a mean of 513. 03 ml [95% confidence interval （ C I） （ - 629, - 344）, P 〈 0. 01 ], intra - operative blood loss by a mean of 94.03 ml [ 95% CI （ - 297.97, 91.92）, P = 0. 32 ], post - operative blood loss by a mean of 297.00 ml [ 95% CI （ - 772. 50, 178.05 ）, P = 0. 22 ] . TA significantly reduced the rate of transfusion [ risk difference 0. 29, 95% CI （ -0. 40, -0. 17）, P 〈0. 01 ] and transfusion unit [ mean difference 0. 99, 95% CI （ - 1.48, - 0.49）, P 〈 0.01 ] . The risks between TA group and placebo group in develo- ping deep - vein thrombosis （DVT） and pulmonary embolism （PE） were not statistically significant. [ Conclusion] The use of TA could significantly reduce total blood loss, the rate of transfusion and transfusion unit in patients undergoing TKA. TA does not lead to an increasing risk of DVT and PE.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2012年第13期1172-1177,共6页
Orthopedic Journal of China
关键词
氨甲环酸
关节成形术
置换
膝
失血
荟萃分析
tranexamic acid, arthroplasty, replacement, knee, blood loss, meta - analysis
