氨甲环酸局部与静脉应用在初次单侧全髋关节置换围手术期安全性及有效性的Meta分析

发布时间：2018-04-22 21:26

本文选题：局部 + 关节腔　；参考：《中国矫形外科杂志》2017年15期

【摘要】：[目的]用Meta分析的方法探讨局部与静脉应用氨甲环酸(tranexamic acid,TXA)对全髋关节置换术(total hip arthroplasty,THA)的安全性及有效性。[方法]计算机检索Pub Med、EBSCO、The Cochrane Library数据库、中国知网、万方数据库,检索内容为关于局部应用TXA减少THA出血量的临床随机对照试验(randomized controlled trial,RCT)和半随机对照试验(q RCT),检索时限为1999年1月~2016年6月。按纳入、排除标准进行文献筛选和质量评估,应用Rev Man 5.2软件进行Meta分析。[结果]纳入8篇文献,2 144例患者,局部应用氨甲环酸组789例,静脉组1 355例。Meta分析结果显示:(1)安全性:局部组与静脉组相比,术后深静脉血栓(DVT)发生率[RR=0.76,95%CI(0.22,2.59),P=0.66]、肺栓塞(PE)发生率[RR=0.73,95%CI(0.08,7.02),P=0.79]、切口感染率[RR=1.26,95%CI(0.54,2.93),P=0.59]差异均无统计学意义;(2)有效性:局部组与静脉组对比,术后总失血量[WMD=16.75,95%CI(-30.07,63.57),P=0.48]、血红蛋白下降值[WMD=0.30,95%CI(0.02,0.58),P=0.03]、输血率[RR=1.37,95%CI(0.97,1.93),P=0.07]差异均无统计学意义。[结论]初次单侧全髋关节置换术局部应用氨甲环酸与静脉应用相比具有相当的安全性和有效性。
[Abstract]:[objective] to investigate the safety and efficacy of local and intravenous application of tranexamic acid (TXA) in total hip arthroplasty for total hip arthroplasty (THAs). [methods] the Cochrane Library database was searched by computer in Pub Medsite. The contents of the search were randomized controlled trialoma (RCTT) and semi-randomized control trial (QRCTs), which were used to reduce the amount of THA bleeding. The search time was from January 1999 to June 2016. Literature screening and quality evaluation were carried out according to inclusion and exclusion criteria, and Meta analysis was carried out with Rev Man 5.2 software. [results] A total of 2 144 patients were included in 8 literatures, 789 patients were treated locally with carbamate, and 1 355 patients were given intravenous administration. The results of Meta-analysis showed that the safety of the local group was higher than that of the venous group. The incidence of DVT was 0.22 / 2.59 P0.66, the incidence of PE was 0.087.02 / 0.79, and the rate of incision infection [RRN1.2695CI0.542.93CI0.542.93C / P0.59] was not statistically significant (P 0.59): the local group was compared with the intravenous group, and there was no significant difference between the local group and the venous group. The total blood loss [WMD-16.75-95CI-30.07], hemoglobin decreased [WMD-0.30 ~ 95CIQ 0.03], and the blood transfusion rate [RRN1.3795 CI 0.971.93P0.07] had no statistical significance. [conclusion] the primary unilateral total hip replacement is safe and effective compared with intravenous application.
【作者单位】：滨州医学院附属医院骨关节外科;
【基金】：山东省自然科学基金(编号:ZR2015PH006)
【分类号】：R687.4

【相似文献】