特兰克萨姆酸用于通过皮肤进行瘤切除
Brent Cleveland1,2, Brett Norling3, Hill Wang3
1Department of Urology, University of Minnesota, Minneapolis, Minnesota, USA.
The Cochrane database of systematic reviews
|October 26, 2023
概括
系统性特兰胺酸 (TXA) 可以减少输血和结石的皮肤透神经切除术 (PCNL) 期间的并发症. 然而,它可能会增加不良事件,对其他结果产生不确定的影响.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 穿皮骨切除术 (PCNL) 是大型结石的标准,但存在出血风险.
- 特兰胺酸 (TXA) 是一种抗纤维素解毒剂,用于减轻出血并发症.
研究的目的:
- 评估TXA在接受PCNL治疗结石患者的疗效和安全性.
主要方法:
- 一项全面的文献搜索确定了10项随机对照试验 (RCT),涉及1883名参与者.
- 在PCNL期间系统TXA的使用与安慰剂或没有TXA进行了比较.
- 主要结局包括输血,无结石率 (SFR) 和血栓栓塞事件 (TEE);次要结局包括不良事件 (AE),并发症和住院时间 (LOS).
主要成果:
- 系统性TXA可能会减少输血 (证据确定性低) 和重大手术并发症 (中度确定性).
- 它可能会提高无石头率 (低确定性) 和减少医院LOS (低确定性).
- 然而,TXA可能会增加不良事件 (低确定性),其对血栓栓塞事件的影响可能是可以忽略不计的 (中等确定性).
结论:
- 在PCNL中,全身TXA可能有助于减少输血和并发症,并改善SFRs.
- 需要考虑不良事件的潜在增加.
- 风险试验的方法限制影响证据的确定性,需要明智的临床决策.
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