系统性与灌中tranexamic acid在皮肤性利切除术中的作用 一个系统性综述,贝叶斯网络元分析和元回归
David E Hinojosa-Gonzalez1, Bhaskar Somani2, Daniel Olvera-Posada3
1Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States.
概括
特兰胺酸 (TXA) 降低了皮肤透神经切除术 (PCNL) 的出血和并发症. 与系统性TXA (TXA-S) 相比,用灌液 (TXA-I) 给药TXA在降低输血风险和并发症方面显示出更好的结果.
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) 是大型结石的标准治疗方法.
- 血液流失是PCNL的重要并发症,影响结果.
- 在PCNL期间,正在探索胺酸 (TXA) 减轻出血.
研究的目的:
- 对TXA在PCNL中的疗效进行贝叶斯网络元分析.
- 为了比较系统TXA (TXA-S) 和内灌TXA (TXA-I).
- 评估TXA对出血,并发症和输血率的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查将于2022年2月之前发表.
- 贝叶斯网络元分析,结合马尔科夫链蒙特卡洛采样.
- 包括英语和西班牙语学习,不包括其他语言.
主要成果:
- 与TXA-S相比,TXA-I显示了输血 (RR 0.63) 和并发症 (RR 0.38) 的风险较低.
- 与TXA-S相比,TXA-I还显示了手术后血红蛋白减少的更大减少 (MD-1.2)
- 与安慰剂相比,TXA-S和TXA-I都有效减少出血和并发症.
结论:
- 在PCNL中,TXA有效地降低了出血,并发症和输血风险,不管服用途径如何.
- 内部灌TXA (TXA-I) 似乎比系统TXA (TXA-S) 更有效.
- 需要进一步的研究来确认最佳的TXA注射途径.
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