氨甲环酸术前应用减少高危剖宫产术中及术后出血量的安全性和有效性：一项随机对照试验。
Safety and efficacy of preoperative tranexamic acid in reducing intraoperative and postoperative blood loss in high-risk women undergoing cesarean delivery: a randomized controlled trial.
机构信息
Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, 366 Fardos gardens, 6 October, Giza, 12543, Egypt.
Department of obstetrics and gynecology, Ain Shams University, Cairo, Egypt.
出版信息
BMC Pregnancy Childbirth. 2022 Mar 14;22(1):201. doi: 10.1186/s12884-022-04530-4.
BACKGROUND
Objective to assess the value of preoperative tranexamic acid (TXA) in reduction of intraoperative and postoperative blood loss in high-risk cesarean delivery (CD).
METHODS
A double blind randomized controlled trial included 160 high risk women who underwent elective lower segment CD. They were equally randomized to receive either 1 g of TXA or placebo 15 min before surgery. The primary outcome was Intraoperative blood loss.
RESULTS
The estimated blood loss was significantly higher in the placebo group when compared to TXA group (896.81 ± 519.6 vs. 583.23 ± 379.62 ml, P < 0.001). Both postoperative hemoglobin and hematocrit were lower (9.2 ± 1.6 and 27.4 ± 4.1 vs. 10.1 ± 1.2 and 30.1 ± 3.4, P values < 0.001and 0.012 respectively) and their change percentages (15.41 vs. 7.11%, P < 0.001) were higher in the placebo group when compared to TXA one. The need for further ecbolics was higher in placebo group when compared to TXA group (46.25 vs. 13.75%, P < 0.001).
CONCLUSION
Preoperative TXA is safe and effective in reducing blood loss during and after high-risk CD.
TRIAL REGISTRATION
ClincalTrial.gov ID: NCT03820206 .
背景
目的评估术前氨甲环酸（TXA）减少高危剖宫产术中及术后失血的价值。
方法
一项双盲随机对照试验纳入 160 例择期行下段剖宫产的高危产妇。将其随机等分为 TXA 组和安慰剂组，分别于术前 15min 给予 1gTXA 或安慰剂。主要结局为术中失血量。
结果
与 TXA 组相比，安慰剂组的估计失血量明显更高（896.81±519.6 比 583.23±379.62ml，P<0.001）。术后血红蛋白和红细胞压积均较低（9.2±1.6 和 27.4±4.1 比 10.1±1.2 和 30.1±3.4，P 值均<0.001 和 0.012），且安慰剂组的变化百分比（15.41%比 7.11%，P<0.001）也高于 TXA 组。与 TXA 组相比，安慰剂组需要进一步使用宫缩剂的比例更高（46.25%比 13.75%，P<0.001）。
结论
术前 TXA 安全、有效，可减少高危剖宫产术中及术后的失血。
试验注册
ClincalTrial.gov 注册号：NCT03820206。
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