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在关节镜术中使用特兰克萨姆酸可以减少出血,但不会增加严重并发症的风险:系统性审查

Paul B Walker¹, Mathangi Sridharan¹, Adrian Lin¹

¹University of California, Los Angeles, Los Angeles, California, U.S.A.

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

|March 14, 2026

概括

特兰胺酸 (TXA) 有效地减少了关节镜术期间的出血,而不会增加重大并发症. 虽然它提供了短期的疼痛缓解,但并不能持续改善长期的功能,可视化或手术效率.

科学领域:

整形外科手术整形外科手术
运动医学运动医学
麻醉学麻醉学

背景情况:

关节透视术是治疗关节疾病的常见手术.
尽量减少血液损失和优化患者的康复是手术的关键目标.
特兰胺酸 (TXA) 是一种抗纤维解质剂,用于减少各种手术环境中的出血.

研究的目的:

为了评估酸 (TXA) 对关节镜检查结果的影响.
评估对出血,功能恢复,疼痛,并发症,可视化和手术效率的影响.

主要方法:

在遵守PRISMA指南的基础上进行系统审查.
在PubMed,Embase和Cochrane数据库中搜索到2025年3月.
包括RCT和关节透视术中静脉TXA的比较研究;分析了血液损失,可视化,手术时间,疼痛,并发症和功能.

主要成果:

TXA显著减少了手术前和手术后的血液损失 (P < .01).
没有观察到手术内可视化或手术时间的持续改善.
观察到适度的短期疼痛减轻;没有长期的功能益处. 使用TXA的并发症率较低 (P < .01),但这在很大程度上归因于缩小的神经炎,可能是偶然的.
血栓塞栓事件,感染或修订率没有显著差异.

结论:

在关节镜术中使用TXA有效地减少出血,而不会增加重大并发症风险.
可能提供短期的疼痛缓解和早期的功能改善,但缺乏长期的功能益处.
TXA不能可靠地增强可视化或减少手术时间;最佳剂量需要进一步研究.

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