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膝関節整形手術における経口および静脈注射のトランキサム酸の等価性:ランダム化臨床試験の体系的レビューおよびメタ解析
Hua Luo1, Zhenghua Hong1, Liwei Zhang1
1Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
International journal of surgery (London, England)
|September 2, 2025
まとめ
膝関節整形手術における血流管理には,静脈内投与のTXAと同じくらい有効です. この発見は,患者のケアを簡素化し,潜在的にコストを削減する実行可能な臨床的代替手段として口服TXAを支持します.
科学分野:
- 整形 術
- 薬理学について
- 証拠 に 基づく 医学
背景:
- トラネキサム酸 (TXA) は,関節整形手術で流血を減らすために使用される一般的な抗繊維解消剤です.
- TXAの投与 (経口 vs. 静脈注射) を最適化することは,患者のアウトカムと医療の効率性にとって極めて重要です.
研究 の 目的:
- 膝関節整形手術を受けた患者で,経口と静脈注射のトランキサム酸 (TXA) の有効性と安全性を比較する.
- 異なるTXA投与経路が血流,輸血率,その他の臨床結果に与える影響を評価する.
主な方法:
- PRISMAのガイドラインに準拠したランダム化対照試験 (RCT) の体系的レビューとメタ分析.
- 膝関節整形手術における口投与対静脈投与のTXAを比較した研究では,ヘモグロビン濃度,失血,合併症などの結果が評価されました.
- ランダム効果モデルを用いたデータ合成で,プールの推定値と異質性を評価する.
主要な成果:
- 術後のヘモグロビン,ヘモグロビン低下,血圧値,手術中の血流量,合併症,入院に関して,経口と静脈TXAの間で有意な差異は観察されなかった.
- 術後投与された静脈TXAは,経口TXAと比較して,より長い手術時間に関連していました.
結論:
- 経口用トランキサム酸 (TXA) は,膝関節整形手術の文脈で静脈内投与と同等の有効性と安全性を示しています.
- 経口TXAは,膝関節整形手術の患者にとって,静脈内投与の実用的で効果的な代替品です.
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