Wang Dongdong, Wang Lixia, Wang Yifei, Lin Xinyan
Department of Neurology Department of Gynaecology and Obstetrics, The Second Hospital of Dalian Medical University, Liaoning, China.
Medicine (Baltimore). 2017 Jun;96(23):e7072. doi: 10.1097/MD.0000000000007072.
This meta-analysis aimed to perform a meta-analysis including randomized controlled trials (RCTs) to assess the efficiency and safety of tranexamic acid (TXA) for reducing blood loss and transfusion requirements in patients undergoing open myomectomy.
A systematic search was performed in Medline (1966-2017.03), PubMed (1966-2017.03), Embase (1980-2017.03), ScienceDirect (1985-2017.03,) and the Cochrane Library. Study evaluated the efficiency and safety of TXA in myomectomy was selected. Meta-analysis was performed using Stata 11.0 software.
Four RCTs including 328 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of total blood loss (standard mean difference [SMD] = -1.512, 95% confidence interval [CI]: -2.746 to -0.278, P = .016), postoperative hemoglobin level (SMD = 0.650, 95% CI: 0.045-1.255, P = .035), transfusion requirements (SMD = -0.102, 95% CI: -0.199 to -0.006, P = .038), and duration of surgery (SMD = -0.514, 95% CI: -0.749 to -0.280, P = .000). In addition, no adverse effect was identified in treatment groups.
Intravenous administration of TXA in open myomectomy was associated with significantly reduced total blood loss, postoperative hemoglobin decline, duration of surgery, and transfusion requirements. Based on the limitations of the current meta-analysis, high-quality RCTs with long-term follow-up are still required.
本荟萃分析旨在进行一项包括随机对照试验(RCT)的荟萃分析,以评估氨甲环酸(TXA)在减少接受开放性子宫肌瘤切除术患者的失血和输血需求方面的有效性和安全性。
在Medline(1966 - 2017.03)、PubMed(1966 - 2017.03)、Embase(1980 - 2017.03)、ScienceDirect(1985 - 2017.03)和Cochrane图书馆进行了系统检索。选择评估TXA在子宫肌瘤切除术中有效性和安全性的研究。使用Stata 11.0软件进行荟萃分析。
四项包括328例患者的RCT符合纳入标准。本荟萃分析表明,两组在总失血量(标准均差[SMD] = -1.512,95%置信区间[CI]:-2.746至-0.278,P = 0.016)、术后血红蛋白水平(SMD = 0.650,95% CI:0.045 - 1.255,P = 0.035)、输血需求(SMD = -0.102,95% CI:-0.199至-0.006,P = 0.038)和手术时间(SMD = -0.514,95% CI:-0.749至-0.280,P = 0.000)方面存在显著差异。此外,治疗组未发现不良反应。
开放性子宫肌瘤切除术中静脉注射TXA与总失血量、术后血红蛋白下降、手术时间和输血需求的显著减少相关。基于当前荟萃分析的局限性,仍需要进行长期随访的高质量RCT。