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氨甲环酸在减少全膝关节置换术中失血的疗效

EFFICACY OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS IN TOTAL KNEE ARTHROPLASTY.

作者信息

Sadigursky David, Araujo Larissa Martins, Fernandes Rogério Jamil Carneiro

机构信息

. Faculdade de Tecnologia e Ciências de Salvador, Salvador, BA, Brazil.

. Center for Studies in Orthopedics and Traumatology at the Clínica Ortopédica Traumatológica (CEOT COT), Salvador, BA, Brazil.

出版信息

Acta Ortop Bras. 2018 Jan-Feb;26(1):63-66. doi: 10.1590/1413-785220182601149210.

Abstract

OBJECTIVE

To evaluate the efficacy of tranexamic acid in reducing blood loss in total knee arthroplasty by examining the existing literature.

METHOD

This literature review investigated the use of tranexamic acid in knee arthroplasty. The search was performed in the Pubmed, Science Direct, Google Scholar, and Lilacs databases over a 20-year period using the keywords: "knee arthroplasty, tranexamic acid, and efficacy". Only randomized clinical trials published between 2000 and 2016 in English, Spanish, or Portuguese were accepted, and only trials which scored above 3 on the Jadad scale were selected.

RESULTS

A total of 7 randomized clinical trials met the inclusion criteria, with a sample of 948 patients.

CONCLUSION

The use of tranexamic acid in total knee arthroplasty (unilateral or bilateral) reduces perioperative and postoperative blood loss more than other available antifibrinolytics. With this reduction in total blood loss and the need for blood transfusions without any increase in side effects, the use of tranexamic acid can be considered safe and effective in controlling bleeding after knee arthroplasties. Level of Evidence II; Systematic review.

摘要

目的

通过查阅现有文献,评估氨甲环酸在全膝关节置换术中减少失血的疗效。

方法

本文献综述调查了氨甲环酸在膝关节置换术中的应用情况。在20年期间,使用关键词“膝关节置换术、氨甲环酸和疗效”在PubMed、Science Direct、谷歌学术和Lilacs数据库中进行检索。仅纳入2000年至2016年间发表的、语言为英语、西班牙语或葡萄牙语的随机临床试验,且仅选择Jadad评分高于3分的试验。

结果

共有7项随机临床试验符合纳入标准,样本量为948例患者。

结论

在全膝关节置换术(单侧或双侧)中使用氨甲环酸比其他可用的抗纤溶药物能减少围手术期和术后失血。随着总失血量的减少以及输血需求的降低,且无任何副作用增加,氨甲环酸在控制膝关节置换术后出血方面可被认为是安全有效的。证据级别II;系统评价。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f0/6025505/eb9872507fa8/1413-7852-aob-26-01-00063-gf1.jpg

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