Oral and Maxillofacial Surgery Senior House Officer, AlKhobar, Saudi Arabia.
Associate Professor, College of Dentistry, Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates.
J Stomatol Oral Maxillofac Surg. 2023 Dec;124(6 Suppl 2):101592. doi: 10.1016/j.jormas.2023.101592. Epub 2023 Aug 7.
This study aimed to review the currently available evidence on the effectiveness of administering tranexamic acid (TXA) to patients undergoing orthognathic surgery.
A study protocol was developed in accordance with the Preferred Reporting Guideline for Overviews of Reviews (PRIOR) and registered on the International Prospective Register of Systematic Reviews (PROSPERO) under Registration No. CRD42021232931. Furthermore, the reporting of the present systematic review was performed based on the PRISMA checklist.
The search strategy yielded a total of 50 articles. After reading the abstracts, 28 articles were excluded, and the English full texts of the remaining 22 studies were separately examined for eligibility by two authors; 15 articles were excluded because they did not meet the inclusion criteria. Finally, seven systematic reviews and meta-analysis satisfied the criteria for inclusion and were processed for critical review evaluation.
Within the limits of the present study and the reviews of the 7 articles included, it is observed that TXA is able to reduce the amount of intraoperative blood loss and the amount of irrigation fluids required. However, it does not influence postoperative levels of hemoglobin or hematocrit, nor does it affect the requirement for blood transfusions. It was interestingly discovered that TXA could increase the quality of the surgical site. These data imply that TXA may be an effective adjuvant in lowering bleeding during orthognathic surgery. As a result, the potential risk of problems related with considerable blood loss may be minimized.
本研究旨在回顾目前关于在正颌手术中给予氨甲环酸（TXA）有效性的证据。
根据首选报告综述指南（PRIOR）制定了研究方案，并在国际系统评价注册中心（PROSPERO）上以注册号 CRD42021232931 进行了注册。此外，本系统评价的报告是根据 PRISMA 清单进行的。
搜索策略共产生了 50 篇文章。阅读摘要后，排除了 28 篇文章，然后由两位作者分别单独检查其余 22 篇研究的英文全文以确定其是否符合纳入标准；由于不符合纳入标准，排除了 15 篇文章。最后，有 7 篇系统评价和荟萃分析符合纳入标准，并进行了关键评估评价。
在本研究和纳入的 7 篇综述的范围内，可以观察到 TXA 能够减少术中失血量和灌洗液的量。然而，它并不影响术后血红蛋白或红细胞压积水平，也不影响输血需求。有趣的是，TXA 可以提高手术部位的质量。这些数据表明，TXA 可能是降低正颌手术出血的有效辅助手段。因此，与大量失血相关的问题的潜在风险可能会降低。
