Teng Thomas Zheng Jie, Chia Alys Zhi Qin, Gan Keith Fei, Tan Lydia Hui Peng, Wang Yuxing, Charn Tze Choong
Ministry of Health Holdings, Singapore, Singapore.
Department of Otorhinolaryngology - Head and Neck surgery, Sengkang General Hospital, Singhealth, Singapore.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3018-3030. doi: 10.1007/s12070-024-04579-x. Epub 2024 Mar 18.
Nasal surgeries (e.g.: rhinoplasties, septoplasties) and sinus surgeries (e.g.: Functional Endoscopic Sinus Surgeries) are common procedures in Otorhinolaryngology. Tranexamic acid (TXA), an antifibrinolytic drug, has been increasingly utilized to reduce hemorrhage recently. While close in proximity anatomically, the bleeding nature of sinus and nasal surgeries may differ. We present the first meta-analysis that has reviewed both nasal and sinus surgery collectively and compares the two. Pubmed, Embase, Cochrane Library and WoS were searched until April 2023. Outcomes of interest include Boezart Scoring, clotting time, postoperative complications and surgical field quality. 27 Studies were assessed, of which 25 studies were evaluated quantitatively. Of the 27 studies, 15 studies involved Sinus surgery while 12 involved Nasal surgery. The use of tranexamic acid was notably beneficial in the evaluation of blood loss, reduction of operating time, surgical field quality and surgeon satisfaction. TXA has proven to be efficacious in both nasal and sinus surgeries to varying degrees. TXA has more effects in sinus surgeries compared to nasal surgeries in objective markers such as reducing blood loss and operating time, but the converse occurs for subjective markers such as surgeon satisfaction scores.
The online version contains supplementary material available at 10.1007/s12070-024-04579-x.
鼻科手术（如：隆鼻术、鼻中隔成形术）和鼻窦手术（如：功能性鼻内镜鼻窦手术）是耳鼻喉科常见的手术。氨甲环酸（TXA）是一种抗纤维蛋白溶解药物，近年来越来越多地被用于减少出血。虽然鼻窦和鼻科手术在解剖位置上相近，但出血性质可能不同。我们进行了首次荟萃分析，综合回顾了鼻科和鼻窦手术，并对两者进行了比较。检索了截至2023年4月的PubMed、Embase、Cochrane图书馆和Web of Science。感兴趣的结果包括博伊扎特评分、凝血时间、术后并发症和手术视野质量。评估了27项研究，其中25项研究进行了定量评估。在这27项研究中，15项涉及鼻窦手术，12项涉及鼻科手术。使用氨甲环酸在评估失血、减少手术时间、手术视野质量和外科医生满意度方面显著有益。已证明氨甲环酸在鼻科和鼻窦手术中均有不同程度的疗效。在减少失血和手术时间等客观指标方面，氨甲环酸在鼻窦手术中的作用比鼻科手术更大，但在外科医生满意度评分等主观指标方面则相反。
在线版本包含可在10.1007/s12070-024-04579-x获取的补充材料。
