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氨甲环酸对改善关节镜下肩袖修补术视觉清晰度及手术时间的疗效:一项系统评价与Meta分析

Efficacy of tranexamic acid in improving visual clarity and operative time of arthroscopic rotator cuff repair: A systematic review and meta-analysis.

作者信息

Qian Yushun, Jiang Anqing, Yan Jun, Zhang Shouchun, Zhu Siqiang

机构信息

Department of Orthopedics, !e Second People's Hospital of Xiangcheng District, Suzhou, China.

Department of Anesthesiology, !e Second People's Hospital of Xiangcheng District, Suzhou, China.

出版信息

Acta Orthop Traumatol Turc. 2024 Dec 31;58(6):318-325. doi: 10.5152/j.aott.2024.24008.

Abstract

OBJECTIVE

The aim of this study was to examine if tranexamic acid (TXA) can assist in improving outcomes of arthroscopic rotator cu! repair (RCR).

METHODS

The databases of PubMed, Embase, Web of Science, CENTRAL, and Scopus were searched for all types of studies examining the e"cacy of TXA for arthroscopic RCR. Twelve studies, 10 randomized controlled trials (RCTs), and 2 retrospective studies were considered eligible.

RESULTS

Meta-analysis of only 2 studies using a visual clarity grading system showed better visualization with the use of TXA. A similar di!erence was noted for studies using the visual analog scale. Operating time was not significantly di!erent between the groups, but subgroup analysis of RCTs demonstrated reduced operating time with TXA. Meta-analysis showed no di!erence in 24-hour pain scores between TXA and control groups. Qualitative assessment of studies for blood loss showed no significant e!ect of TXA. No major complications were reported in any of the studies.

CONCLUSION

This study has pooled evidence suggesting that TXA can improve visual clarity in arthroscopic RCR and may also result in a reduction in operating time. TXA does not seem to reduce blood loss or 24-hour postoperative pain scores.

LEVEL OF EVIDENCE

Level II, Therapeutic Study.

摘要

目的

本研究旨在探讨氨甲环酸(TXA)是否有助于改善关节镜下肩袖修复术(RCR)的疗效。

方法

检索PubMed、Embase、Web of Science、CENTRAL和Scopus数据库,查找所有研究TXA对关节镜下RCR疗效的各类研究。12项研究被认为符合条件,其中10项为随机对照试验(RCT),2项为回顾性研究。

结果

仅对2项使用视觉清晰度分级系统的研究进行的荟萃分析显示,使用TXA时可视化效果更好。使用视觉模拟量表的研究也发现了类似差异。两组之间的手术时间无显著差异,但RCT的亚组分析表明TXA可缩短手术时间。荟萃分析显示,TXA组和对照组在24小时疼痛评分上无差异。对失血研究的定性评估表明TXA无显著效果。所有研究均未报告重大并发症。

结论

本研究汇总的证据表明,TXA可提高关节镜下RCR的视觉清晰度,还可能缩短手术时间。TXA似乎不会减少失血量或术后24小时疼痛评分。

证据水平

二级,治疗性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e37/11740232/a88a09aee7a1/aott-58-6-318_f001.jpg

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