Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Int J Surg. 2018 Apr;52:334-341. doi: 10.1016/j.ijsu.2018.01.040. Epub 2018 Feb 3.
The efficacy of tranexamic acid (TXA) plus drain-clamping in reducing blood loss after total knee arthroplasty (TKA) is controversial. This meta-analysis aimed to identify whether combined tranexamic acid and drain-clamping was superior to TXA alone, drain clamping alone and control treatments.
We searched the PubMed, EMBASE, Web of Science and Google databases and the Cochrane Database of Systematic Reviews. Patients prepared for primary TKA and who underwent TXA plus drain-clamping for blood loss were included in this meta-analysis. Outcomes included the need for transfusion, total blood loss, blood loss in drainage, a decrease in hemoglobin and the occurrence of deep venous thrombosis (DVT). Stata 12.0 was used for meta-analysis.
Finally, 7 clinical studies with 839 patients were included in this meta-analysis. Compared with the control group, TXA group and drain clamping group treatments, TXA plus drain-clamping could reduce the need for transfusion, total blood loss, blood loss in drainage and the decrease in hemoglobin with statistically significance.
TXA plus drain-clamping is an efficient method for controlling blood loss after TKA, and more studies should focus on the optimal clamping duration.
氨甲环酸（TXA）联合引流夹闭在减少全膝关节置换术（TKA）后失血方面的疗效存在争议。本荟萃分析旨在确定联合使用氨甲环酸和引流夹闭是否优于单独使用 TXA、单独使用引流夹闭和对照组治疗。
我们检索了 PubMed、EMBASE、Web of Science 和 Google 数据库以及 Cochrane 系统评价数据库。本荟萃分析纳入了准备行初次 TKA 且接受 TXA 联合引流夹闭以减少失血的患者。结局包括输血需求、总失血量、引流液失血量、血红蛋白下降和深静脉血栓形成（DVT）的发生。使用 Stata 12.0 进行荟萃分析。
最终，本荟萃分析纳入了 7 项包含 839 例患者的临床研究。与对照组、TXA 组和引流夹闭组相比，TXA 联合引流夹闭可显著减少输血需求、总失血量、引流液失血量和血红蛋白下降。
TXA 联合引流夹闭是控制 TKA 后失血的有效方法，应开展更多研究以确定最佳夹闭时间。
