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局部与系统性特兰胺酸相比,以减少膝盖和关节整形术后的血液损失:系统性审查和元分析

Maude Boucher¹, Juliette Tremblay¹, Théo Pelet¹

¹Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.

The Journal of bone and joint surgery. American volume

|August 5, 2025

概括

局部和全身特兰胺酸 (TXA) 在减少关节和膝关节置换期间的血液损失方面表现出类似的有效性. 然而,局部TXA在膝盖手术中更有效,而全身TXA在部手术中更有效.

科学领域:

整形外科手术整形外科手术
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:

特兰胺酸 (TXA) 用于减少在全膝关节整形术 (TKA) 和全关节整形术 (THA) 中的血液损失.
最佳的TXA施用方法 (局部或全身) 尚不清楚.

研究的目的:

为了比较局部与全身三胺酸 (TXA) 在减少手术流失的疗效.
评估二次结果,包括输血需求,血红蛋白水平,住院和不良事件.

主要方法:

随机对照试验 (RCT) 的系统审查和元分析.
在MEDLINE,Embase和Cochrane CENTRAL搜索相关研究.
包括选择性TKA和THA患者,比较局部和全身TXA给药.

主要成果:

当结合TKA和THA时,局部和全身TXA之间的血液损失没有显著差异 (Hedges g = 0.11).
亚组分析显示,局部TXA显著减少了TKA的血液损失 (g = 0.19),而系统TXA在THA中更有效.
在血红蛋白下降,输血需求或住院时间方面没有观察到显著差异.

结论:

当TKA和THA一起分析时,局部和系统TXA同样有效.
局部TXA在TKA中显示出优异的降低血液损失,而系统TXA在THA中更有效.
需要进一步的研究来确定最佳的TXA剂量和给药途径.

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