全膝关节置换术中氨甲环酸局部注射和经静脉注射两种途径对减少术后出血的有效性及安全性的Meta分析

发布时间：2019-04-18 09:29

【摘要】：目的:目的通过Meta分析对比关节腔注射和静脉注射氨甲环酸(TXA)对减少全膝关节置换(TKA)术后出血作用的有效性及安全性差异。方法:通过计算机检索Cochrane Library、Embase、Pubmed英文数据库以及万方数据库,中国知网中文数据库中2015年1月到2016年6月所有关于关节腔注射和静脉注射TXA治疗全膝关节置换术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 5.2软件进行Meta分析。结果:结果共纳入6篇文献,纳入患者578例,其中局部应用关节腔注射TXA288例,静脉注射TXA 290例。关节腔注射与静脉注射TXA在术前血红蛋[MD=0.08,95C l%(-0.09,0.24)P=0.36]、术后血红蛋白量[MD=0.10,Cl95%(-0.12,0.31)P=0.38],术前红细胞压积量[MD=-0.34,Cl95%(-1.23,0.54)P=0.45],术后红细胞压积[M D=-0.09,Cl95%(-2.07,1.90)P=0.93],总失血[MD=0.93,Cl95%(0.21,4.16)P=0.92]术后输血率[MD=-0.45,Cl95%(-1.20,0.29)P=0.23],住院天数[MD=1.50,Cl95%(0.62,3.66)P=0.37]及血栓事件的发生[MD=1.50,Cl95%(0.62,3.66)P=0.37]方面差异均无统计学意义。结论:结论是关节腔内注射与静脉注射氨甲环酸在减少全膝关节置换手术术后出血的有效性和安全性并无差异,两种给药方式均可以减少TKA术后出血且两种给药途径在深静脉血栓和肺栓塞发生率上并没有明显区别。
[Abstract]:Aim: to compare the efficacy and safety of intra-articular injection and intravenous injection of (TXA) in reducing bleeding after total knee arthroplasty (TKA) by Meta analysis. Methods: Cochrane Library,Embase,Pubmed English database and Wanfang database were searched by computer. All clinical randomized controlled trials (RCTs),) between January 2015 and June 2016 in Chinese database of Chinese knowledge website for the treatment of bleeding after total knee arthroplasty with intra-articular injection and intravenous injection of TXA According to the Jadad rating scale, the included literature was graded and Meta analysis was carried out with Revman 5.2 software. Results: a total of 6 articles were included, including 578 patients, including local injection of TXA288 in articular cavity and intravenous injection of TXA in 290cases. Preoperative heme [MD=0.08,95C 1% (- 0. 09, 0. 24) P < 0. 36] and postoperative heme volume [MD=0.10,Cl95% (- 0. 12, 0. 31) p = 0. 38] by intra-articular injection and intravenous injection of TXA. Preoperative hematocrit [MD=-0.34,Cl95% (- 1.23,0.54) P0. 45], postoperative hematocrit [MD=- 0.09, Cl 95% (- 2.07, 1.90) P0. 93], total blood loss [MD=0.93,] Cl95% (0.21, 4.16) P = 0.92] postoperative blood transfusion rate [MD=-0.45,Cl95% (- 1.20, 0.29) P = 0.23], length of hospital stay [MD=1.50,Cl95% (0.62, 3.66) P = 0.37] and occurrence of thrombus events [MD=1.50,] There was no significant difference in Cl95% (0.62, 3.66) P = 0.37. Conclusion: there is no difference in efficacy and safety between intra-articular injection and intravenous injection of carbacycloic acid in reducing postoperative bleeding after total knee arthroplasty. Both methods of administration could reduce bleeding after TKA and there was no significant difference in the incidence of deep venous thrombosis and pulmonary embolism between the two routes.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

【参考文献】