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氨甲环酸在颈椎手术中的疗效与安全性：一项系统评价和荟萃分析。

Efficacy and safety of tranexamic acid in cervical spine surgery: a systematic review and meta-analysis.

作者信息

Luo Hua, Yang Yu, Wang Zhitao, Ma Lingping, Xie Chengxin

机构信息

Department of Orthopedic, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.

Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.

出版信息

Front Neurol. 2024 May 6;15:1405773. doi: 10.3389/fneur.2024.1405773. eCollection 2024.

DOI:10.3389/fneur.2024.1405773
PMID:38770522
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11102962/
Abstract

BACKGROUND

Tranexamic acid (TXA) is an antifibrinolytic drug associated with reduced blood loss in a range of surgical specialties. This meta-analysis aimed to compare the efficacy and safety of TXA in cervical surgery, focusing on its effects on intraoperative blood loss and related outcomes.

METHODS

We searched the PubMed, EMBASE, Medline, and Cochrane Library databases to identify all literature related to TXA used in cervical spinal surgery. Intraoperative blood loss, postoperative drainage volume, total blood loss, postoperative hematological variables, and complications were analyzed.

RESULTS

Eight trials met the inclusion criteria. The pooled results showed that intraoperative blood loss, total blood loss, and postoperative drainage volume were significantly lower in the TXA group than in the control group. The hemoglobin and hematocrit on postoperative day 1 was significantly higher in the TXA group than in the control group. There was no significant difference in complications between the two groups.

CONCLUSION

The available evidence indicates that TXA effectively reduces blood loss in cervical spinal surgery while maintaining a favorable safety profile, without increasing associated risks.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42023459652.

摘要

背景

氨甲环酸（TXA）是一种抗纤溶药物，在一系列外科专业中与减少失血有关。本荟萃分析旨在比较TXA在颈椎手术中的疗效和安全性，重点关注其对术中失血及相关结局的影响。

方法

我们检索了PubMed、EMBASE、Medline和Cochrane图书馆数据库，以识别所有与颈椎手术中使用TXA相关的文献。分析术中失血量、术后引流量、总失血量、术后血液学指标及并发症。

结果

八项试验符合纳入标准。汇总结果显示，TXA组的术中失血量、总失血量和术后引流量显著低于对照组。TXA组术后第1天的血红蛋白和血细胞比容显著高于对照组。两组并发症无显著差异。

结论

现有证据表明，TXA在颈椎手术中可有效减少失血，同时保持良好的安全性，且不增加相关风险。

系统评价注册

https://www.crd.york.ac.uk/prospero/，标识符CRD42023459652。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/ad22f8eab856/fneur-15-1405773-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/06340ecb223e/fneur-15-1405773-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/bb3bba0c2e09/fneur-15-1405773-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/0e0a94c12076/fneur-15-1405773-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/896f49051b45/fneur-15-1405773-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/5f003eecc008/fneur-15-1405773-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/fefdab5692b6/fneur-15-1405773-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/ad22f8eab856/fneur-15-1405773-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/06340ecb223e/fneur-15-1405773-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/bb3bba0c2e09/fneur-15-1405773-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/0e0a94c12076/fneur-15-1405773-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/896f49051b45/fneur-15-1405773-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/5f003eecc008/fneur-15-1405773-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/fefdab5692b6/fneur-15-1405773-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e7/11102962/ad22f8eab856/fneur-15-1405773-g007.jpg

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