Eftekharian Hamidreza, Vahedi Ruhollah, Karagah Tuba, Tabrizi Reza
Assistant Professor of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran.
Postgraduate Student of Oral and Maxillofacial Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
J Oral Maxillofac Surg. 2015 Jan;73(1):129-33. doi: 10.1016/j.joms.2014.07.033. Epub 2014 Aug 1.
Perioperative hemorrhage is an important concern during orthognathic surgery. The purpose of this study was to assess the effect of tranexamic acid (TXA) irrigation on perioperative hemorrhage during orthognathic surgery.
In this double-blind, randomized controlled clinical trial, 56 participants who underwent orthognathic surgery were divided into 2 groups. The patients in the first group received TXA irrigation with normal saline (1 mg/mL), and the patients in the second group had normal saline for irrigation during orthognathic surgery. Age, gender, operation duration, the amount of irrigation solution used, and preoperative hemoglobin, hematocrit, and weight were the variables that were studied. The use of TXA solution for irrigation was the predictive factor of the study.
Each group consisted of 28 patients. Group 1 consisted of 15 male patients (53.6%) and 13 female patients (46.4%) and group 2 consisted of 14 male patients (50%) and 14 female patients (50%). There was no difference in the distributions of the variables between the 2 groups, except for the duration of the operation. The mean duration of the operation was 3.94 ± 0.61 hours in group 1 and 4.17 ± 0.98 hours in group 2, and the difference in this respect between the 2 groups was statistically significant (P < .05). The mean intraoperative blood loss was 817.85 ± 261.83 mL in group 1 and 575.00 ± 286.90 mL in group 2 (P < .05). The mean volume of irrigation was 1,057.14 ± 407.04 mL in group 1 and 843.57 ± 275.48 mL in group 2 (P > .05).
TXA is effective in reducing intraoperative blood loss in patients for whom substantial blood loss is anticipated.
围手术期出血是正颌外科手术期间的一个重要关注点。本研究的目的是评估氨甲环酸（TXA）冲洗对正颌外科手术围手术期出血的影响。
在这项双盲、随机对照临床试验中，56例接受正颌外科手术的参与者被分为2组。第一组患者接受用生理盐水（1mg/mL）配制的TXA冲洗，第二组患者在正颌外科手术期间用生理盐水冲洗。年龄、性别、手术持续时间、冲洗液用量以及术前血红蛋白、血细胞比容和体重是所研究的变量。使用TXA溶液冲洗是本研究的预测因素。
每组由28例患者组成。第一组包括15例男性患者（53.6%）和13例女性患者（46.4%），第二组包括14例男性患者（50%）和14例女性患者（50%）。除手术持续时间外，两组之间变量的分布没有差异。第一组的平均手术持续时间为3.94±0.61小时，第二组为4.17±0.98小时，两组在这方面的差异具有统计学意义（P<.05）。第一组的平均术中失血量为817.85±261.83mL，第二组为575.00±286.90mL（P<.05）。第一组的平均冲洗量为1057.14±407.04mL，第二组为843.57±275.48mL（P>.05）。
对于预期有大量失血的患者，TXA在减少术中失血方面有效。
