Department of Otorhinolaryngology, Habib Bourguiba Hospital, Sfax, Tunisia.
University of Sfax, Sfax, Tunisia.
Ann Otol Rhinol Laryngol. 2023 Mar;132(3):244-249. doi: 10.1177/00034894221086086. Epub 2022 Apr 2.
Our aim is to evaluate the effect of topical tranexamic acid (TA) on bleeding and surgical quality field in the functional endoscopic sinus surgery (FESS).
A total of 74 patients who underwent FESS due to chronic rhinosinusitis were included. The patients were randomized into 2 groups. TA group (n = 37) received a topical cotton pledget soaked with TA and placebo (PL) group (n = 37) received a pledget soaked with saline solution.
A significant effect was noted for the TA group versus the PL group in the grade 1 of the Boezaart scale at 35 minutes (4 for TA group and no case for PL group). This effect was absent for higher grades. We did not notice a significant effect between the 2 groups at 5 minutes. Blood loss was 359 ml in the TA group versus 441 ml in the PL group. No significant change was observed between the 2 groups concerning the blood parameters. No side effects were reported.
Despite its safety when administrated locally and its low cost, TA provides limited effect on quality of surgical field after 35 minutes of the start of FESS in the patients with chronic rhinosinusitis. This effect was absent at the start of the intervention and when analyzing the blood loss and hematologic parameters.
评估局部使用氨甲环酸（TA）对功能性内窥镜鼻窦手术（FESS）中出血和手术视野质量的影响。
共纳入 74 例因慢性鼻-鼻窦炎而行 FESS 的患者。将患者随机分为 2 组，TA 组（n=37）接受局部浸有 TA 的棉片，安慰剂（PL）组（n=37）接受浸有生理盐水的棉片。
在 35 分钟时，与 PL 组相比，TA 组 Boezaart 量表的 1 级（TA 组为 4 级，PL 组无）有显著效果。较高等级无显著效果。在 5 分钟时，两组之间无显著差异。TA 组的失血量为 359ml，PL 组为 441ml。两组的血液参数无明显变化。未报告任何不良反应。
尽管 TA 局部使用安全且成本低廉，但在慢性鼻-鼻窦炎患者 FESS 开始后 35 分钟，其对手术视野质量的影响有限。这种效果在干预开始时以及分析出血量和血液参数时并不存在。
