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评价局部应用氨甲环酸控制鼻中隔成形术引起的出血。

Evaluation of applying topical tranexamic acid to control septorhinoplasy - induced hemorrhage.

机构信息

Otorhinolaryngology Research Center, Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Clinical Research Development Unit of Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Am J Otolaryngol. 2022 Sep-Oct;43(5):103514. doi: 10.1016/j.amjoto.2022.103514. Epub 2022 Jun 4.

Abstract

OBJECTIVES

Hemorrhagic events related to surgical field is a common disturbing complication which could worsen the outcomes of operation. This study aimed to evaluate how applying of topical tranexamic acid (TXA) could affect bleeding related to septorhinoplasty operation.

MATERIAL AND METHODS

This double-blind controlled trial study finally evaluated 198 candidates for septorhinoplasty repair who were randomly allocated to two groups: TXA receivers (5 mg/kg) and control group (received 5 mg/kg of saline 0.9 %). Then cumulative volume of hemorrhage was calculated by adding total volume of suctioned blood and numbers of fully blood-filled surgical gauzes (15 mL in each). Additionally postoperative 24 h volume of hemorrhage was measured by counting number of bloody surgical gauzes.

RESULTS

Of all participants, 90 % were female. The mean age was 26 ± 7 years. Total cumulative volume of hemorrhage during surgery was significantly diminished when topical TXA was applied (p < 0.0001). Additionally drier field of operation was illustrated postoperatively in patients received topical TXA (2 % & 28 % in TXA and saline 0.9 % receivers, respectively) (p < 0.001).

CONCLUSION

Using topical TXA could decrease bleeding volume and make surgical field of septorhinoplasty drier either during surgery or postoperatively.

摘要

目的

与手术部位相关的出血事件是一种常见的令人困扰的并发症,可能会使手术结果恶化。本研究旨在评估局部应用氨甲环酸(TXA)如何影响鼻中隔成形术手术中的出血情况。

材料和方法

本双盲对照试验最终评估了 198 名鼻中隔成形术修复候选人,他们被随机分配到两组:TXA 组(5mg/kg)和对照组(接受 5mg/kg 的生理盐水 0.9%)。然后通过添加抽吸的血液总量和充满血液的手术纱布数量(每个 15mL)来计算总出血量。此外,通过计算血性手术纱布的数量来测量术后 24 小时的出血量。

结果

所有参与者中,90%为女性。平均年龄为 26±7 岁。当局部应用 TXA 时,手术过程中的总累计出血量明显减少(p<0.0001)。此外,接受局部 TXA 的患者术后手术部位更干燥(分别为 TXA 和生理盐水 0.9%受体的 2%和 28%)(p<0.001)。

结论

使用局部 TXA 可以减少出血量,并使鼻中隔成形术的手术部位在手术期间或术后更干燥。

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