Department of Trauma Center, Huaihe Hospital of Henan University, Kaifeng 475000, China.
Department of Trauma Orthopedics, Zaozhuang Municipal Hospital, No. 41 Longtou Road, Zaozhuang City, Shandong Province, China.
J Healthc Eng. 2021 Nov 3;2021:1758066. doi: 10.1155/2021/1758066. eCollection 2021.
At present, the effect of tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA) on total knee arthroplasty (TKA) remains controversial. Therefore, the aim of this meta-analysis is to compare the differences between the effects of TXA and EACA in TKA.
We used electronic databases, including PubMed, Embase, MEDLINE, Ovid, ScienceDirect, Cochran Library, Google Scholar, clinical trial, and Chinese related databases, for literature search to find any effect of TXA and EACA in TKA. The differences between groups were compared by odds ratio (OR), weighted mean difference (WMD), and 95% confidence interval (CI). A total of four studies, including 3 randomized controlled trials (RCT) and 1 cohort study, were involved in this meta-analysis, involving 1836 participants. Among these participants, 816 belonged to the TXA group and 1020 belonged to the EACA group.
Meta-analysis indicated no difference in surgery time (WMD = 0.01, 95% CI -0.35 to 0.36), total amount of blood loss (WMD = 0.14, 95% CI -0.09 to 0.37), transfusion rate (OR = 0.74, 95% CI 0.20 to 2.78), transfusion units per patient (SMD = -0.15, 95% CI -0.54 to 0.25), complications (OR = 0.75, 95% CI 0.37 to 1.55), and length of stay (SMD = -0.01, 95% CI -0.11 to 0.08).
Our results suggest that the effect of TXA is not superior to EACA in TKA. However, this conclusion still needs to be further confirmed by multicenter and large-sample clinical trials.
目前，氨甲环酸（TXA）和氨基己酸（EACA）对全膝关节置换术（TKA）的影响仍存在争议。因此，本荟萃分析的目的是比较 TXA 和 EACA 在 TKA 中的效果差异。
我们使用电子数据库，包括 PubMed、Embase、MEDLINE、Ovid、ScienceDirect、Cochrane 图书馆、Google Scholar、临床试验和中文相关数据库，进行文献检索，以寻找 TXA 和 EACA 在 TKA 中的任何效果。通过优势比（OR）、加权均数差（WMD）和 95%置信区间（CI）比较组间差异。共有四项研究，包括三项随机对照试验（RCT）和一项队列研究，纳入本荟萃分析，共涉及 1836 名参与者。其中，816 名参与者属于 TXA 组，1020 名参与者属于 EACA 组。
荟萃分析表明手术时间（WMD=0.01，95%CI-0.35 至 0.36）、总失血量（WMD=0.14，95%CI-0.09 至 0.37）、输血率（OR=0.74，95%CI0.20 至 2.78）、每位患者输血单位数（SMD=-0.15，95%CI-0.54 至 0.25）、并发症（OR=0.75，95%CI0.37 至 1.55）和住院时间（SMD=-0.01，95%CI-0.11 至 0.08）无差异。
我们的结果表明，TXA 的效果并不优于 EACA 在 TKA 中。然而，这一结论仍需要通过多中心、大样本临床试验进一步证实。
