Department of Orthopedics, People's Fourth Hospital of Sichuan Province, 1666 Minjiang Road, Jinjiang District, Chengdu, Sichuan, PR China.
Asian J Surg. 2023 Aug;46(8):3033-3045. doi: 10.1016/j.asjsur.2022.10.078. Epub 2022 Nov 14.
This meta-analysis aimed to assess whether administration tranexamic acid (TXA) could reduce blood loss and vascular events in patients undergoing unicompartmental knee arthroplasty (UKA). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and case control trials (CCT) that compared outcomes of patients who did and did not receive TXA during UKA. We searched Cochrane Central Register of including PubMed, EMBASE, Web of Science, the Cochrane Library, Wan Fang data, CBM and CNKI for relevant studies. We assessed the risk of bias of the included studies and calculated pooled risk estimates. The primary outcome was operation time, intraoperative blood loss, postoperative HCT, postoperative HB, transfusion rate, dominant blood loss, postoperative drainage volume, hidden blood loss, total blood loss, postoperative ROM,postoperative VAS score, postoperative complications. Data were using fixed-effects or random-effects models with standard mean differences and risk ratios for continuous and dichotomous variables, respectively. Finally, 9 clinical studies with 744 patients were included in this meta-analysis. Compared with the control group, TXA group could reduced transfusion rate, dominant blood loss, postoperative drainage volume, hidden blood loss, and total blood loss, and increased postoperative HB with statistically significance. The main findings of this meta-analysis are that the transfusion rate, dominant blood loss, postoperative drainage volume, hidden blood loss, total blood loss and postoperative HB in the tranexamic acid group were superior to those in the routine group. Additional high-quality RCTs should be conducted in the future.
本荟萃分析旨在评估在接受单髁膝关节置换术（UKA）的患者中使用氨甲环酸（TXA）是否可以减少失血和血管事件。我们对比较 UKA 期间使用和未使用 TXA 的患者结局的随机对照试验（RCT）和病例对照试验（CCT）进行了系统评价和荟萃分析。我们在 Cochrane 中央注册包括 PubMed、EMBASE、Web of Science、Cochrane 图书馆、万方数据、CBM 和中国知网等数据库中搜索了相关研究。我们评估了纳入研究的偏倚风险，并计算了汇总风险估计。主要结局指标是手术时间、术中失血量、术后 HCT、术后 HB、输血率、显性失血量、术后引流量、隐性失血量、总失血量、术后 ROM、术后 VAS 评分、术后并发症。使用固定效应或随机效应模型，分别对连续和二分类变量进行标准均数差和风险比的计算。最终，这项荟萃分析纳入了 9 项包含 744 例患者的临床研究。与对照组相比，TXA 组的输血率、显性失血量、术后引流量、隐性失血量和总失血量减少，术后 HB 增加，差异具有统计学意义。这项荟萃分析的主要发现是，氨甲环酸组的输血率、显性失血量、术后引流量、隐性失血量、总失血量和术后 HB 均优于常规组。未来应该进行更多高质量的 RCT。
