Haddady-Abianeh Shahriar, Rahmati Javad, Delavari Changiz, Molaei Hojjat
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Plastic and Reconstr-uctive Surgery, Faculty of Medicine, Razi Hospital, Tehran, Iran.
World J Plast Surg. 2022;11(3):24-27. doi: 10.52547/wjps.11.3.24.
Bleeding during rhinoplasty surgery has a negative effect on the quality of surgery; so, it is important to reduce bleeding during rhinoplasty. We aimed to evaluate the effect of injectable tranexamic acid (TXA) and nasal spray of desmopressin (DDAVP) on reduction in intraoperative bleeding and ecchymosis after open rhinoplasty.
In a Randomized Clinical Trial ( RCT) prepared since 2020 to 2021 in Razi Hospital and Imam Khomeini Hospital, Tehran, Iran on 42 patients who underwent open rhinoplasty were divided into three groups. In the first group, TXA was injected one hour before surgery at a dose of 10 mg / kg with a placebo inhalation spray. In the second group, DDAVP was administered as a nasal spray at a dose of 40 mcg with a placebo injection. The third group received a placebo spray and placebo injection. All required data were gathered and analyzed.
In TXA group and DDAVP groups, the volume of bleeding during surgery significantly (=0.022) decreased compared to placebo group, also, the quality of the surgical field and the surgeon's satisfaction significantly (=0.007) improved compared to the placebo group but not with each other. Unlike placebo group, there were no reports of postoperative bleeding in the TXA and DDAVP groups. Duration of surgery, ecchymosis on the day after surgery and coagulation tests before and after surgery were not significantly different in three groups.
Use of DDAVP and TXA can both reduce the amount of bleeding during surgery and postoperative bleeding in rhinoplasty and improve the quality of the surgical field and the surgeon 's satisfaction during surgery.
鼻整形手术中的出血会对手术质量产生负面影响；因此，减少鼻整形手术中的出血很重要。我们旨在评估注射用氨甲环酸（TXA）和去氨加压素鼻喷雾剂（DDAVP）对开放性鼻整形术后术中出血减少和瘀斑形成的影响。
在2020年至2021年于伊朗德黑兰的拉齐医院和伊玛目霍梅尼医院开展的一项随机临床试验（RCT）中，对42例行开放性鼻整形术的患者分为三组。第一组在手术前1小时注射TXA，剂量为10mg/kg，并使用安慰剂吸入喷雾剂。第二组以40mcg的剂量使用DDAVP鼻喷雾剂，并注射安慰剂。第三组接受安慰剂喷雾剂和安慰剂注射。收集并分析所有所需数据。
与安慰剂组相比，TXA组和DDAVP组手术期间的出血量显著减少（=0.022），手术视野质量和外科医生的满意度也比安慰剂组显著提高（=0.007），但两组之间无差异。与安慰剂组不同，TXA组和DDAVP组均未报告术后出血情况。三组的手术时间、术后第一天的瘀斑情况以及手术前后的凝血测试无显著差异。
使用DDAVP和TXA均可减少鼻整形手术中的出血量和术后出血，并提高手术视野质量和外科医生在手术期间的满意度。
