ElAbd Rawan, Richa Yasmina, Pouramin Panthea, Dow Todd, AlNesef Meshari, Safran Tyler, Gilardino Mirko, Samargandi Osama A
Aesthet Surg J. 2025 Jan 16;45(2):171-179. doi: 10.1093/asj/sjae193.
Liposuction is the most frequently performed cosmetic procedure. Tranexamic acid (TXA) has emerged as a promising blood loss reducing agent in plastic surgery, but its value in liposuction is still being studied. This systematic review investigates the safety and efficacy of TXA in reducing blood loss during liposuction procedures. A systematic review of PubMed, EMBASE, and Cochrane databases from inception to June 2023 was performed. The primary objective was to compare blood loss, hematoma rate, and ecchymosis from liposuction procedures in patients who received TXA with those who did not. The secondary objective was to assess the incidence of TXA-related complications. A total of 9 studies were included, published between 2018 and 2023, of which 8 were prospective and 1 was retrospective. A total of 345 intervention vs 268 control arms were compared. Follow-up time ranged from 1 to 14 days. Mean age and mean BMI ranged from 33 to 50 years and 23 to 30 kg/m2, respectively. Blood loss in aspirate was significantly less with TXA administration as assessed in 5 studies (P < .05). Of the 5 studies that described assessment of the incidence of ecchymosis, all reported less bruising with TXA use. Among all the studies, only 1 reported postoperative complications in 5 patients requiring transfusion in the control group (without TXA). The evidence provided in the literature suggests that TXA administration in liposuction is safe and effective for reducing blood loss and ecchymosis by both intravenous and local administration.
抽脂术是最常进行的美容手术。氨甲环酸（TXA）已成为整形外科中一种有前景的减少失血的药物，但其在抽脂术中的价值仍在研究中。本系统评价调查了TXA在抽脂手术中减少失血的安全性和有效性。对PubMed、EMBASE和Cochrane数据库从创建到2023年6月进行了系统评价。主要目的是比较接受TXA的患者与未接受TXA的患者在抽脂手术中的失血量、血肿发生率和瘀斑情况。次要目的是评估TXA相关并发症的发生率。共纳入9项研究，发表于2018年至2023年之间，其中8项为前瞻性研究，1项为回顾性研究。共比较了345个干预组与268个对照组。随访时间为1至14天。平均年龄和平均BMI分别为33至50岁和23至30 kg/m2。5项研究评估显示，使用TXA时吸出物中的失血量显著减少（P <.05）。在5项描述瘀斑发生率评估的研究中，所有研究均报告使用TXA后瘀伤较少。在所有研究中，只有1项研究报告对照组（未使用TXA）中有5例患者术后出现需要输血的并发症。文献提供的证据表明，抽脂术中使用TXA通过静脉和局部给药减少失血和瘀斑是安全有效的。
