Department of Orthopaedic Surgery, Monash Health Dandenong Hospital, Dandenong, VIC, Australia.
Radiology Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
J Shoulder Elbow Surg. 2024 Feb;33(2):e97-e108. doi: 10.1016/j.jse.2023.09.024. Epub 2023 Oct 26.
The effect of tranexamic acid (TXA) has been proven to be effective in reducing blood loss in lower limb arthroplasty. The aim of this study is to investigate the effect of TXA in shoulder surgery with the updated studies.
A systematic review and meta-analysis of all the randomized controlled trials were conducted. We compared the outcomes of patients with and without TXA. The PubMed, MEDLINE, EMBASE, and CENTRAL databases were systematically searched for relevant studies.
A total of 14 studies, enrolling 1131 patients, were included for qualitative and quantitative analysis. Our results revealed that TXA was associated with a significant reduction in total volume blood loss (mean difference [MD]: -112.97, P = .0006), drain output (MD: -81.90, P < .00001), hemoglobin changes (MD: -0.55, P = .02), shorter operative time (MD: -6.19, P = .01), and lower risk of hematoma formation (odds ratio: -0.20, P = .01). The postoperative visual analog scale pain score was also significantly better in the TXA group (MD: -0.78, P < .00001). No significant difference was detected in length of hospital stay and incidence of thromboembolization.
The usage of TXA in shoulder surgery appeared to be safe and effective in reducing blood loss without any significant complication.
氨甲环酸（TXA）已被证明可有效减少下肢关节置换术的失血量。本研究旨在通过最新研究调查 TXA 在肩部手术中的效果。
对所有随机对照试验进行系统回顾和荟萃分析。我们比较了使用 TXA 和未使用 TXA 的患者的结果。系统检索了 PubMed、MEDLINE、EMBASE 和 CENTRAL 数据库中的相关研究。
共纳入 14 项研究，共计 1131 例患者，进行定性和定量分析。我们的结果表明，TXA 与总失血量（均数差 [MD]：-112.97，P=0.0006）、引流液量（MD：-81.90，P<.00001）、血红蛋白变化（MD：-0.55，P=0.02）、手术时间缩短（MD：-6.19，P=0.01）和血肿形成风险降低（比值比：-0.20，P=0.01）显著相关。TXA 组术后视觉模拟评分疼痛也显著降低（MD：-0.78，P<.00001）。两组患者的住院时间和血栓栓塞发生率无显著差异。
在肩部手术中使用 TXA 似乎是安全有效的，可以减少出血，且无明显并发症。
