Rio de Janeiro, Brazil; Newark, N.J.; and New York, N.Y.
From the Department of Plastic Surgery, Universidade Iguaçu, Hospital da Plástica; the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School; and the Hansjörg Wyss Department of Plastic and Reconstructive Surgery, New York University Langone Medical Center.
Plast Reconstr Surg. 2018 May;141(5):1132-1135. doi: 10.1097/PRS.0000000000004282.
The use of tranexamic acid for blood loss prevention has gained popularity in many specialties, including plastic surgery. However, its use in liposuction has not been studied. The authors present a prospective, double-blind, nonrandomized study evaluating the efficacy of tranexamic acid in reducing perioperative blood loss during liposuction.
Twenty women undergoing liposuction were divided into two cohorts. Group 1 (n = 10) received a standard dose of 10 mg/kg of tranexamic acid intravenously in the preoperative and postoperative periods, whereas group 2 (n = 10) received a placebo. Patient hematocrit levels were evaluated preoperatively and postoperatively. Blood volume in the infranatant of the lipoaspirate was also measured; t tests were used for statistical analysis.
Age, body mass index, and volume of lipoaspirate were comparable between the two cohorts. The volume of blood loss for every liter of lipoaspirate was 56.2 percent less in the tranexamic group compared with the control group (p < 0.001). Hematocrit levels at day 7 postoperatively were 48 percent less in group 1 compared with group 2 (p = 0.001). Furthermore, a 1 percent drop in the hematocrit level was found after liposuction of 812 ± 432 ml in group 1 and 379 ± 204 ml in group 2. Thus, the use of tranexamic acid could allow for aspiration of 114 percent more fat, with comparable variation in hematocrit levels.
Tranexamic acid has been shown to be effective for minimizing perioperative blood loss in liposuction. Further large randomized controlled studies are required to corroborate this effect.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
氨甲环酸在许多专业领域，包括整形外科学，已被广泛应用于预防失血。然而，它在吸脂术中的应用尚未得到研究。作者提出了一项前瞻性、双盲、非随机研究，评估氨甲环酸在减少吸脂术围手术期失血方面的疗效。
20 名接受吸脂术的女性患者被分为两组。组 1（n = 10）患者在术前和术后静脉内给予标准剂量的 10 mg/kg 氨甲环酸，而组 2（n = 10）患者给予安慰剂。患者术前和术后的血细胞比容水平进行了评估。还测量了吸脂吸出物的下层血容量；使用 t 检验进行统计学分析。
两组患者的年龄、体重指数和吸脂量无差异。与对照组相比，氨甲环酸组每升吸脂出血量减少 56.2%（p < 0.001）。术后第 7 天，组 1 的血细胞比容水平比组 2 低 48%（p = 0.001）。此外，组 1 在吸脂 812 ± 432 ml 后，血细胞比容水平下降了 1%，而组 2 则下降了 379 ± 204 ml。因此，使用氨甲环酸可以允许抽吸 114%更多的脂肪，同时血细胞比容水平变化相似。
氨甲环酸已被证明可有效减少吸脂术围手术期失血。需要进一步的大型随机对照研究来证实这一效果。
临床问题/证据水平：治疗性，II 级。
