Wu Yuangang, Yang Timin, Zeng Yi, Si Haibo, Cao Fei, Shen Bin
aDepartment of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China bDepartment of Orthopaedic Surgery, People's Hospital of Tibet Autonomous Region, Lasa, China *Yuangang Wu and Timin Yang contributed equally to this work and should be considered as equal first authors.
Blood Coagul Fibrinolysis. 2017 Oct;28(7):501-508. doi: 10.1097/MBC.0000000000000637.
: The aim of this meta-analysis is to assess the effectiveness and safety of intravenous application tranexamic acid (TXA) in primary simultaneous bilateral total knee arthroplasty (TKA). We searched electronic databases including PubMed, Embase, the Web of Science, the Cochrane Library and the Google Scholar, for published studies involving the intravenous application TXA in primary simultaneous bilateral TKA. All randomized controlled trials were included. The focus of the meta-analysis was on the outcomes of total blood loss, drainage volume, transfusion requirements and deep venous thrombosis (DVT) and/or pulmonary embolism. The relevant data were analyzed using RevMan 5.2. Six high randomized controlled trials were included, with a total sample size of 394 patients. The intravenous application of TXA significantly reduced total blood loss [95% confidence interval (CI), -519.52 to -126.40; P = 0.001], drainage volume (95% CI, -551.76 to -138.57; P = 0.001) and transfusion requirements (risk ratio, 0.38; 95% CI, 0.21-0.68; P = 0.001) compared with the control group. In addition, there were no significant differences in the rate of DVT (P = 1.00) and/or pulmonary embolism between the two groups. Based on the current evidence, this meta-analysis showed that intravenous application of TXA is effective and a well tolerated treatment to reduce total blood loss, drainage volume and transfusion requirements without increasing the risk of DVT and/or pulmonary embolism in primary simultaneous bilateral TKA.
本荟萃分析的目的是评估静脉应用氨甲环酸（TXA）在初次同期双侧全膝关节置换术（TKA）中的有效性和安全性。我们检索了包括PubMed、Embase、科学网、Cochrane图书馆和谷歌学术在内的电子数据库，以查找涉及静脉应用TXA于初次同期双侧TKA的已发表研究。纳入所有随机对照试验。荟萃分析的重点是总失血量、引流量、输血需求以及深静脉血栓形成（DVT）和/或肺栓塞的结果。使用RevMan 5.2对相关数据进行分析。纳入了6项高质量随机对照试验，总样本量为394例患者。与对照组相比，静脉应用TXA显著减少了总失血量[95%置信区间（CI），-519.52至-126.40；P = 0.001]、引流量（95%CI，-551.76至-138.57；P = 0.001）和输血需求（风险比，0.38；95%CI，0.21 - 0.68；P = 0.001）。此外，两组之间DVT和/或肺栓塞的发生率无显著差异（P = 1.00）。基于当前证据，本荟萃分析表明，静脉应用TXA是一种有效且耐受性良好的治疗方法，可减少初次同期双侧TKA的总失血量、引流量和输血需求，而不会增加DVT和/或肺栓塞的风险。
