Sallam Hany F, Shady Nahla W
Department of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt.
J Obstet Gynaecol India. 2019 Apr;69(2):173-179. doi: 10.1007/s13224-018-1149-x. Epub 2018 Jul 3.
To assess the effect of intravenous versus topical tranexamic acid in reducing intraoperative and postoperative blood loss in women with abdominal hysterectomy.
The study was a randomized double-blind placebo-controlled trial, carried out in a tertiary university hospital in Egypt, from November 2015 to October 2017. A total of 129 women undergoing abdominal hysterectomy for benign etiology were randomly assigned to three groups: Group I [43 patients received 110 ml normal saline IV just before skin in scion], Group II [43 patients received 1 g tranexamic acid in 100 ml saline IV just before skin in scion], and Group III [43 patients received 2 g topical tranexamic acid applied intra-abdominal after hysterectomy]. The primary outcome was intraoperative, postoperative, and all blood loss estimation.
Both Group II (IV tranexamic acid) and Group III (topical tranexamic acid application) showed great reduction in intraoperative and postoperative blood loss (blood in the intra-abdominal drain) compared with Group I (placebo group), ( = 0.0001, 0.0001, 0.0001, 0.0001), so the overall estimated blood loss in groups II and III showed highly reduction compared with Group I ( = 0.0001, 0.0001).
Intravenous and topical tranexamic acid application is a safe and reliable method to help decrease blood loss during and after abdominal hysterectomy.
评估静脉注射与局部应用氨甲环酸对腹式子宫切除术女性术中及术后失血的影响。
本研究为一项随机双盲安慰剂对照试验，于2015年11月至2017年10月在埃及一所三级大学医院进行。共有129例因良性病因接受腹式子宫切除术的女性被随机分为三组：第一组[43例患者在皮肤切开前静脉输注110毫升生理盐水]，第二组[43例患者在皮肤切开前静脉输注100毫升含1克氨甲环酸的生理盐水]，第三组[43例患者在子宫切除术后腹腔内应用2克局部氨甲环酸]。主要结局指标为术中、术后及总失血量评估。
与第一组（安慰剂组）相比，第二组（静脉注射氨甲环酸）和第三组（局部应用氨甲环酸）的术中及术后失血量（腹腔引流管中的血液）均显著减少（P = 0.0001, 0.0001, 0.0001, 0.0001），因此第二组和第三组的总体估计失血量与第一组相比显著减少（P = 0.0001, 0.0001）。
静脉注射和局部应用氨甲环酸是一种安全可靠的方法，有助于减少腹式子宫切除术期间及术后的失血量。
