摘要
目的 通过meta分析评价膝关节镜下前交叉韧带重建术患者术中使用氨甲环酸的有效性和安全性。方法 对Embase、Cochrane Library、PubMed、万方数据库、维普数据库、中国知网数据库进行检索,检索的时间范围从建库截至2022年9月,收集所有膝关节镜下前交叉韧带重建术患者术中使用氨甲环酸的随机对照试验。结局指标包括术后失血量、术后关节腔穿刺率、术后血肿发生率、术后视觉模拟评分法评分、术后膝关节活动度。选用RevMan 5.3分析软件进行meta分析。结果 纳入分析的文献共有6篇,涉及病例共计660例。Meta分析结果显示,氨甲环酸组患者的术后失血量低于对照组[加权均数差(weighted mean difference,WMD)=-24.32mL,95%置信区间(confidence interval,CI)(-33.73 mL,-14.91 mL),P<0.000 01]。氨甲环酸组患者的术后视觉模拟评分法评分低于对照组[WMD=-0.69分,95%CI(-1.21分,-0.18分),P=0.009]。氨甲环酸组患者的术后膝关节活动度高于对照组[WMD=2.88°,95%CI(0.55°,5.21°),P=0.02]。氨甲环酸组患者的术后关节腔穿刺率低于对照组[危险比(risk ratio,RR)=0.25,95%CI(0.12,0.53),P=0.000 3]。氨甲环酸组患者的术后血肿形成率低于对照组[RR=0.40,95%CI(0.21,0.78),P=0.007]。结论 术中使用氨甲环酸的膝关节镜下前交叉韧带重建术患者,其术后出血量更少,膝关节穿刺率和血肿形成率降低,有利于疼痛缓解及功能康复。
Objective To evaluate the efficacy and safety of tranexamic acid in arthroscopic anterior cruciate ligament reconstruction by meta-analysis. Methods The databases searched included Embase, PubMed, Cochrane Library, Wanfang, China National Knowledge Infrastructure and Chongqing VIP. The search time range was from the establishment of the databases to September 2022. All randomized controlled trials using tranexamic acid in arthroscopic anterior cruciate ligament reconstruction were collected. The outcome indicators were postoperative blood loss,postoperative joint cavity puncture rate, postoperative hematoma rate, postoperative Visual Analogue Scale score, and postoperative knee joint range of motion. RevMan 5.3 analysis software was selected for meta-analysis. Results A total of 6 articles were included, including 660 patients. Meta-analysis showed that the postoperative blood loss in the tranexamic acid group was lower than that in the control group [weighted mean difference(WMD)=-24.32 mL, 95%confidence interval(CI)(-33.73 mL,-14.91 mL), P<0.000 01]. The postoperative Visual Analogue Scale score in the tranexamic acid group was lower than that in the control group [WMD=-0.69, 95%CI(-1.21,-0.18), P=0.009]. The postoperative knee joint range of motion in the tranexamic acid group was higher than that in the control group[WMD=2.88°, 95%CI(0.55°, 5.21°), P=0.02]. The postoperative joint cavity puncture rate in the tranexamic acid group was lower than that in the control group [risk ratio(RR)=0.25, 95%CI(0.12, 0.53), P=0.000 3]. The postoperative hematoma rate in the tranexamic acid group was lower than that in the control group [RR=0.40, 95%CI(0.21, 0.78),P=0.007]. Conclusion The patients who used tranexamic acid in in arthroscopic anterior cruciate ligament reconstruction have less postoperative bleeding, lower knee joint puncture rate and hematoma formation rate, which are conducive to pain relief and functional rehabilitation.
作者
刘凯
王永才
黄秋
王红川
LIU Kai;WANG Yongcai;HUANG Qiu;WANG Hongchuan(Department of Orthopedics,People's Hosipital of Leshan,Leshan,Sichuan 614000,P.R.China)
出处
《华西医学》
CAS
2022年第10期1531-1537,共7页
West China Medical Journal
关键词
前交叉韧带重建术
氨甲环酸
META分析
随机对照试验
Anterior cruciate ligament reconstruction
tranexamic acid
meta-analysis
randomized controlled trial
