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氨甲环酸在全髋关节置换术中的应用：随机对照试验和队列研究的混合治疗比较

Tranexamic acid in total hip arthroplasty: Mixed treatment comparisons of randomized controlled trials and cohort studies.

作者信息

Sridharan Kannan, Sivaramakrishnan Gowri

机构信息

Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.

School of Oral Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.

出版信息

J Orthop. 2018 Jan 17;15(1):81-88. doi: 10.1016/j.jor.2018.01.051. eCollection 2018 Mar.

DOI:10.1016/j.jor.2018.01.051
PMID:29657445
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5895930/
Abstract

BACKGROUND

The present study is a network meta-analysis of various routes of tranexamic acid (TXA) in patients with total hip arthroplasty (THA).

METHODS

Randomized controlled trials and cohort studies evaluating TXA in patients with THA were included. Number of patients requiring blood transfusion was the primary outcome.

RESULTS

Pooled estimate for TXA use against placebo for blood transfusion rate was 0.30 [0.23, 0.39] favoring TXA. Maximum reduction in the risk of blood transfusion was observed with topical plus intra-operative intravenous TXA.

CONCLUSION

Combined topical and intravenous TXA during surgery may perform better than other modes in patients undergoing THA.

摘要

背景

本研究是对全髋关节置换术（THA）患者中氨甲环酸（TXA）不同给药途径的网络荟萃分析。

方法

纳入评估THA患者使用TXA的随机对照试验和队列研究。输血患者数量为主要结局指标。

结果

TXA与安慰剂相比，输血率的合并估计值为0.30[0.23, 0.39]，表明TXA更具优势。局部联合术中静脉注射TXA时，输血风险降低幅度最大。

结论

在接受THA的患者中，手术期间联合局部和静脉注射TXA可能比其他给药方式效果更好。

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本文引用的文献

1
Tranexamic acid in total hip arthroplasty: A recursive cumulative meta-analysis of randomized controlled trials and assessment of publication bias.氨甲环酸在全髋关节置换术中的应用：随机对照试验的递归累积荟萃分析及发表偏倚评估。
J Orthop. 2017 May 21;14(3):323-328. doi: 10.1016/j.jor.2017.05.004. eCollection 2017 Sep.
2
Combined application versus topical and intravenous application of tranexamic acid following primary total hip arthroplasty: a meta-analysis.初次全髋关节置换术后氨甲环酸联合应用与局部及静脉应用的比较：一项荟萃分析
BMC Musculoskelet Disord. 2017 Feb 21;18(1):90. doi: 10.1186/s12891-017-1429-0.
3
Intravenous Combined with Topical Administration of Tranexamic Acid in Primary Total Hip Arthroplasty: A Randomized Controlled Trial.静脉联合局部应用氨甲环酸在初次全髋关节置换术中的随机对照试验
Orthop Surg. 2017 May;9(2):174-179. doi: 10.1111/os.12287. Epub 2017 Jan 17.
4
OBTAIN A: Outcome Benefits of Tranexamic Acid in Hip Arthroplasty. A Randomized Double-Blinded Controlled Trial.氨甲环酸在髋关节置换术中的疗效益处：一项随机双盲对照试验
J Arthroplasty. 2017 May;32(5):1516-1519. doi: 10.1016/j.arth.2016.11.045. Epub 2016 Dec 8.
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Medicine (Baltimore). 2016 Dec;95(50):e5583. doi: 10.1097/MD.0000000000005583.
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Rev Esp Cir Ortop Traumatol. 2016 Sep-Oct;60(5):315-24. doi: 10.1016/j.recot.2016.05.001. Epub 2016 Jun 21.
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J Arthroplasty. 2016 Nov;31(11):2548-2553. doi: 10.1016/j.arth.2016.03.059. Epub 2016 Apr 12.
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