Department of Orthopaedic Surgery, Monash Health Dandenong Hospital, Dandenong, VIC, Australia.
Royal Perth Hospital, Perth, WA, Australia.
Eur J Orthop Surg Traumatol. 2023 Dec;33(8):3327-3335. doi: 10.1007/s00590-023-03612-z. Epub 2023 Jun 17.
To evaluate the effectiveness of combined Tranexamic acid (TXA) and dexamethasone (DEX) in total hip and knee arthroplasty.
PUBMED, EMBASE, MEDLINE and CENTRAL database were systematically searched for randomized studies that utilized TXA and DEX administration of TXA in THA or TKA.
A total of three randomized studies enrolling 288 patients were eligible for qualitative and quantitative analysis. DEX + TXA group demonstrated statistical significantly lesser usage of oxycodone (OR: 0.34, p < 0.0001), metoclopramide (OR: 0.21, p < 0.00001), lesser incidence of postoperative nausea and vomiting (OR: 0.27, p < 0.0001), better postoperative range of motion (MD: 2.30, p < 0.00001) and shorter length of hospital stay (MD: 0.31, p = 0.03). Comparable results were seen in total blood loss, transfusion rate and postoperative complications.
In this meta-analysis, the combination of TXA and DEX has positive impacts on the usage of oxycodone and metoclopramide, postoperative range of motion, postoperative nausea and vomiting and reduces the length of hospital stay.
评估氨甲环酸（TXA）联合地塞米松（DEX）在全髋关节和全膝关节置换术中的有效性。
系统检索 PUBMED、EMBASE、MEDLINE 和 CENTRAL 数据库中关于 TXA 和 DEX 联合用于 THA 或 TKA 的随机研究。
共有 3 项随机研究纳入了 288 名患者，符合定性和定量分析的条件。DEX+TXA 组在术后使用羟考酮（OR：0.34，p<0.0001）、甲氧氯普胺（OR：0.21，p<0.00001）的用量显著减少，术后恶心和呕吐的发生率较低（OR：0.27，p<0.0001），术后活动范围较好（MD：2.30，p<0.00001），住院时间较短（MD：0.31，p=0.03）。在总失血量、输血率和术后并发症方面也观察到了类似的结果。
在这项荟萃分析中，TXA 和 DEX 的联合使用对羟考酮和甲氧氯普胺的使用、术后活动范围、术后恶心和呕吐以及缩短住院时间有积极影响。
