Sezen Göktaş Seda, Yenigün Alper, Sütcü Ahmet Onur, Özturan Orhan, Tuğrul Selahattin
Department of Otorhinolaryngology, Samsun Education and Research Hospital, 55090, İlkadim, Samsun, Turkey.
Department of Otorhinolaryngology, Bezmialem Vakif University Medical Faculty, Fatih, Istanbul, Turkey.
Aesthetic Plast Surg. 2024 Sep;48(17):3284-3291. doi: 10.1007/s00266-024-03951-0. Epub 2024 Mar 27.
The aim of this study was to evaluate the effectiveness of the intravenous, oral and local application of tranexamic acid in operation time, intraoperative bleeding, postoperative edema and ecchymosis in rhinoplasty.
This was a randomized, double-blinded, prospective study. We included 146 patients who underwent rhinoplasty at the Bezmialem Vakif University Medical Faculty Otorhinolaryngology Clinic between April 2021 and April 2022. The patients were divided into four groups: Group 1 (intravenous TXA), Group 2 (oral TXA), Group 3 (topical TXA), and Group 4 (control). Operation time was recorded. Bleeding volume was measured in the suction chamber and nasopharyngeal pack. Postoperative edema and ecchymosis were evaluated using a scale at the end of the operation, on the 1st, 3rd, and 7th days.
There was no statistically significant difference between groups in terms of mean operation time (p = 0.894). There was a statistically significant lower mean intraoperative bleeding level in Group 2 from the other groups (p = 0.020). Group 3 had significantly lower scores for postoperative edema than the other groups at the end of the operation, on the 1st, 3rd, and 7th days (p < 0.05), and significantly lower scores for postoperative ecchymosis at the end of the operation (p = 0.013) and on the 3rd day (p = 0.024). Although group 3 had a lower score than the other groups in the ecchymosis measurements on the 1st, and 7th days, no statistically significant results were obtained.
Local application of tranexamic acid is founded more beneficial for reducing postoperative edema and ecchymosis in rhinoplasty than intravenous and/or oral applications in this study.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
本研究旨在评估静脉注射、口服和局部应用氨甲环酸对隆鼻手术时间、术中出血、术后水肿和瘀斑的效果。
这是一项随机、双盲、前瞻性研究。我们纳入了2021年4月至2022年4月期间在贝兹米阿勒姆瓦基夫大学医学院耳鼻喉科诊所接受隆鼻手术的146例患者。患者分为四组：第1组（静脉注射氨甲环酸）、第2组（口服氨甲环酸）、第3组（局部应用氨甲环酸）和第4组（对照组）。记录手术时间。在吸引器腔和鼻咽填塞物中测量出血量。在手术结束时、第1天、第3天和第7天使用量表评估术后水肿和瘀斑。
各组平均手术时间之间无统计学显著差异（p = 0.894）。第2组的平均术中出血水平显著低于其他组（p = 0.020）。在手术结束时、第1天、第3天和第7天，第3组的术后水肿评分显著低于其他组（p < 0.05），在手术结束时（p = 0.013）和第3天（p = 0.024）的术后瘀斑评分也显著较低。虽然第3组在第1天和第7天的瘀斑测量中得分低于其他组，但未获得统计学显著结果。
在本研究中，局部应用氨甲环酸在减少隆鼻术后水肿和瘀斑方面比静脉注射和/或口服应用更有益。
证据水平I：本杂志要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
