氨甲环酸在髋部骨折手术中的应用：疗效与安全性的系统评价和荟萃分析
Tranexamic acid in hip fracture surgery: A systematic review and meta-analysis of efficacy and safety.
作者信息
Liu Hsuan-Wei, Lee Shin-Da
机构信息
Department of Public Health, China Medical University, Beitun District, Taichung City, 406040, Taiwan.
Department of Physical Therapy, PhD Program in Healthcare Science, China Medical University, Taichung, 406040, Taiwan.
出版信息
J Orthop. 2024 Dec 27;66:154-164. doi: 10.1016/j.jor.2024.12.028. eCollection 2025 Aug.
BACKGROUND
Meta-analysis assesses the safety and efficacy of Tranexamic Acid (TXA) in patients with hip fracture surgery compared to placebo.
METHODS
On September 28, 2023, qualified RCT studies, including randomized control trials and cohort study, of intravenous Tranexamic Acid (TXA) in patients undergoing hip fracture surgery was searched. Review Manager was used for the meta-analysis.
RESULTS
The TXA group had significantly lower intraoperative total blood loss and overall blood loss across eighteen investigations. The blood transfusion rate in the TXA group was lower than that in placebo group. TXA maintained higher hemoglobin levels on the postoperative first and third day. TXA did not raise any possible complication or problems such as deep vein thrombosis, pulmonary embolism, and mortality.
CONCLUSION
The TXA treatment in patients undergoing hip fracture surgery reduced intraoperative blood loss, overall blood loss, transfusion rate, and length of hospital stay effectively and appeared to be safe to use without significant complication or problems.
背景
与安慰剂相比，荟萃分析评估了氨甲环酸（TXA）在髋部骨折手术患者中的安全性和有效性。
方法
2023年9月28日，检索了关于静脉注射氨甲环酸（TXA）用于髋部骨折手术患者的合格随机对照试验（RCT）研究，包括随机对照试验和队列研究。使用Review Manager进行荟萃分析。
结果
在18项研究中，TXA组的术中总失血量和总失血量显著更低。TXA组的输血率低于安慰剂组。TXA在术后第一天和第三天维持较高的血红蛋白水平。TXA未引发任何可能的并发症或问题，如深静脉血栓形成、肺栓塞和死亡率。
结论
TXA治疗可有效减少髋部骨折手术患者的术中失血量、总失血量、输血率和住院时间，且使用似乎安全，无明显并发症或问题。
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