氨甲环酸在全肩关节置换术中减少失血的疗效：一项荟萃分析。

The efficacy of tranexamic acid in reducing blood loss in total shoulder arthroplasty: A meta-analysis.

作者信息

He Jing, Wang Xi-E, Yuan Guo-Hong, Zhang Lian-Hai

机构信息

Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University Surgical Department, Jinan Infectious Diseases Hospital, Jinan Department of Anesthesiology, Shouguang City People's Hospital, Shouguang City, Shandong Emergency Department, Zaozhuang Municipal Hospital, Zaozhuang, China.

出版信息

Medicine (Baltimore). 2017 Sep;96(37):e7880. doi: 10.1097/MD.0000000000007880.

BACKGROUND

The purpose of this meta-analysis is to compare the efficacy of tranexamic acid (TXA) versus placebo after a total shoulder arthroplasty (TSA).

METHODS

In April 2017, a systematic computer-based search was conducted in the databases of PubMed, Embase, Web of Science, Cochrane Library, and Google. Studies comparing TXA versus placebo in reducing blood loss after TSA were included. The endpoints were the need for transfusion, blood loss in drainage, hemoglobin drop, and total blood loss. Stata 12.0 software was used for the meta-analysis.

RESULTS

Six studies involving a total of 637 patients met the inclusion criteria. The meta-analysis revealed that, compared with control groups, treatment with TXA could decrease the need for transfusion (P < .00001), blood loss in drainage (P = .000), hemoglobin drop (P = .001), and total blood loss (P = .000).

CONCLUSION

TXA can decrease the need for transfusion as well as total blood loss in TSA patients. There was a negative correlation between the TXA dose and the need for transfusion and blood loss in drainage. Because the administration route and the dose of TXA were different, more studies are needed in order to identify the optimal dose and route.