School of Stomatology, Shandong University, 250012, Jinan City, Shandong Province, PR China.
School of Stomatology, Shandong University, 250012, Jinan City, Shandong Province, PR China; Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan City, Shandong Province, PR China.
J Craniomaxillofac Surg. 2019 Apr;47(4):592-601. doi: 10.1016/j.jcms.2019.01.021. Epub 2019 Jan 21.
The objective of this study was to comprehensively assess the use of tranexamic acid (TXA) during orthognathic surgery. A systematic review and meta-analysis of randomized controlled trials addressing these issues were carried out. Three electronic databases, included PubMed, Web of Science, and Cochrane Library, were searched until April 30, 2018. Eligible studies were restricted to randomized, controlled trials (RCTs). Weighted mean differences (WMD) for blood loss, operation time, haematocrit, quality of surgical field, and odds ratio (OR) for transfusion rates were pooled for the included studies. Eight randomized, controlled trials were included for analysis. Compared with the control group, the TXA group showed a reduction in intraoperative blood loss of 165.03 ml (p < 0.00001; 95% CI, -200.93 to -129.13 ml), a reduction in the drop of haematocrit of 2.32 g/dl (p < 0.00001; 95% CI, -3.38 to -1.26 g/dl), and an improved quality of surgical field (p < 0.00001; MD, -1.01; 95% CI, -1.23 to -0.80). Tranexamic acid has a limited effect on reducing operative time (p < 0.00001; MD, -16.18 min; 95% CI, -19.60 to -12.75 min) and on decreasing the transfusion rates (p = 0.02; OR = 0.33; 95% CI, 0.13 to 0.83).
本研究旨在全面评估氨甲环酸（TXA）在正颌手术中的应用。通过系统评价和荟萃分析，对解决这些问题的随机对照试验进行了研究。研究人员检索了三个电子数据库，包括 PubMed、Web of Science 和 Cochrane Library，检索时间截至 2018 年 4 月 30 日。纳入的研究仅限于随机对照试验（RCTs）。对纳入的研究进行加权均数差（WMD）分析，以评估出血量、手术时间、血细胞比容、手术视野质量和输血率的比值比（OR）。共纳入 8 项随机对照试验进行分析。与对照组相比，TXA 组术中失血量减少 165.03ml（p<0.00001；95%CI，-200.93 至-129.13ml），血细胞比容下降 2.32g/dl（p<0.00001；95%CI，-3.38 至-1.26g/dl），手术视野质量得到改善（p<0.00001；MD，-1.01；95%CI，-1.23 至-0.80）。TXA 对缩短手术时间（p<0.00001；MD，-16.18min；95%CI，-19.60 至-12.75min）和降低输血率（p=0.02；OR=0.33；95%CI，0.13 至 0.83）的效果有限。
