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对于慢性腹腔内血瘤使用特兰克萨姆酸是否安全:系统性审查和元分析

Mohammad Amin Habibi¹, Seyed Ahmad Naseri Alavi², Amir Reza Boskabadi³

¹Department of Neurosurgery, Tehran University of Sciences, Shariati Hospital, Tehran, Iran.

Asian journal of neurosurgery

|June 9, 2025

概括

特兰胺酸 (TXA) 显著降低了经过孔骨切除术 (BC) 后慢性腹腔内血瘤 (CSDH) 的复发. 这种辅助疗法还降低了老年患者的重新手术率,血栓栓塞并发症和死亡率.

科学领域:

神经外科神经外科
药理学药理学是指药理学的学科.
基于证据的医学基于证据的医学

背景情况:

在孔骨切除术 (BC) 后,慢性腹腔内血瘤 (CSDH) 的复发仍然是一个临床挑战.
特兰胺酸 (TXA) 作为BC后CSDH的辅助疗法的疗效和安全性尚未得到充分证实.
现有的关于TXA在手术后预防CSDH的数据有限.

研究的目的:

系统地审查和元分析特兰胺酸 (TXA) 的安全性和有效性,以防止在孔骨切除术 (BC) 后的CSDH复发.
评估TXA对接受BC的CSDH患者的再手术率,血栓形成风险和死亡率的影响.

主要方法:

按照PRISMA指南进行系统审查和元分析.
搜索到2024年1月的数据库,查找BCBC后CSDH的TXA随机对照试验和队列研究.
包括10项涉及14836名患者的研究;主要结局是CSDH复发和重新手术;次要结局包括血栓形成和死亡率.

主要成果:

与单独手术相比,TXA作为辅助疗法显著降低了血液瘤复发率到0.05 (95% CI [0.03-0.08],p <0.01).
TXA显示,手术后血瘤复发率显著降低.
在BC后的老年CSDH患者中,TXA使用与重新手术减少,血栓栓塞并发症和死亡率有关.

结论:

特兰克萨姆酸 (TXA) 有效地降低了孔骨切除术 (BC) 后的CSDH复发.
TXA作为一种安全和有益的辅助治疗,降低了重新手术,血栓塞栓事件和死亡率.
这些证据支持TXA在接受CSDH手术治疗的老年患者的使用.

关键词:

慢性皮下血液瘤慢性皮下血液瘤进行骨切除术 (craniotomy).皮下血腫 (subdural hematoma) 是一種皮下血腫.特兰克萨姆酸是什么意思

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